- Molina Healthcare (NY)
- …and audits of the data collected and abstracted from medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The overreader ... projects. **Job Duties** + Performs the role of the HEDIS medical record review overreader/auditor which includes ongoing review...**O** **C** **I** **A** **TI** **O** **N** **:** Active RN license for the State(s) of employment **PHY** **S**… more
- Molina Healthcare (Buffalo, NY)
- …Lead Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The ... lead role in the coordination and preparation of the HEDIS medical record review which includes ongoing review of...**O** **C** **I** **A** **TI** **O** **N** **:** Active RN license for the State(s) of employment **PHY** **S**… more
- Molina Healthcare (Yonkers, NY)
- …for the implementation, monitoring, and oversight of all chart collection for HEDIS , or HEDIS -like projects, Risk Adjustment, Risk Adjustment Data Validation, ... for all CDA team members as well as company HEDIS training, onboarding for CDA team members, vendor management...Certified Professional in Health Quality (CPHQ) * Nursing License ( RN may be preferred for specific roles) * Certified… more
- Catholic Health Services (Melville, NY)
- Overview Position Summary: The Registered Nurse provides safe, direct patient care utilizing the nursing process in the ambulatory setting. The RN provides ... clinical leadership and is a resource for staff. The Registered Nurse must show an uncompromising commitment...in staff meetings and huddles as appropriate. Participates in Hedis , GPRO, and other quality programs as needed Enters… more
- Molina Healthcare (Rochester, NY)
- …in one or more of the following critical QI functional areas: HEDIS Performance Measurement, which conducts data collection, reporting and monitoring for key ... with key departments within Molina and at Molina plans. + Leads HEDIS Performance Measurement programs using knowledge, skills and technical expertise in performance… more
- CVS Health (Albany, NY)
- …products and VPN. **Preferred Qualifications:** + Licensed Allied Health Professional or Licensed Registered Nurse + Coding or Sales background + Certified Six ... related role. + 2+ years of process improvement experience related to HEDIS measures. + In-depth knowledge of healthcare regulations, clinical operations, quality… more
- Catholic Health (Orchard Park, NY)
- …The Medical Assistant is under the clinical supervision of the Licensed Practical Nurse , Registered Nurse , Nurse Practitioner, Physician Assistant ... but not required + Knowledge of Patient Centered Medical Home, with MIPS, HEDIS requirements preferred (Primary Care) WORKING CONDITIONS: + Ability to travel to and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …the use of medical and health care services for members. The SN CHA Nurse may also perform other technical and administrative tasks essential to the efficient ... as DOH, CMS, Medicaid, and accreditation requirements such as NCQA, URAC and HEDIS functionalities are met or exceeded. Accesses Health Commerce System (HCS) and… more
- Centene Corporation (New York, NY)
- …Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set ( HEDIS ) performance. + Ensure health plan is compliant and become/remain ... of healthcare operations experience, including quality improvement experience. **License/Certification:** RN license preferred. Certified Professional in Health Care Quality… more
- Catholic Health (Kenmore, NY)
- …an accredited school of nursing. + Maintains a current New York State Professional RN license + Completion of an accredited program for Nurse Practitioners. + ... Maintains Adult, Acute Care or Family Nurse Practitioner Certification + Master's degree preferred. EXPERIENCE +...+ Knowledge of Patient Centered Medical Home, with MIPS, HEDIS requirements preferred WORKING CONDITIONS: + Work is demanding… more