• Coding Quality Auditor, HEDIS *Remote…

    Providence (Lubbock, TX)
    …auditing within electronic health records. + 1 year - Experience in the medical field as a Medical Assistant, Certified Nurse Assistant, or Licensed Practical ... empower them._** **Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:** + Be responsible for conducting clinical quality audits/overreads… more
    Providence (11/21/25)
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  • Quality Management, Nurse Consultant

    CVS Health (Austin, TX)
    …POSC Council and executive sponsors to advance initiatives aimed to achieve HEDIS and CAHPS goals. Provides insights and recommendations to optimize healthcare ... training and education to healthcare professionals, staff, and stakeholders on HEDIS and CAHPS related performance, workflow, and dependencies. - Collaborates with… more
    CVS Health (10/23/25)
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  • Nurse Case Manager -Senior Care Options…

    Fallon Health (Barnstable, MA)
    …or follow us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary team focused ... policies and processes o Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member...advanced) degree in nursing or a health care related field preferred. **License** : Active, unrestricted license as a… more
    Fallon Health (11/25/25)
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  • Case Manager, Maternity (Registered Nurse )

    Excellus BlueCross BlueShield (Rochester, NY)
    …and scope of practice requirements for each specific health-related field /specialty, + Maintains confidentiality and conducts information management procedures per ... Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, Geriatrics, etc.) to ensure continuity and… more
    Excellus BlueCross BlueShield (11/26/25)
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  • Associate Quality Practice Advisor

    Centene Corporation (Lansing, MI)
    …sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record ... deficiencies impacting plan compliance to meet State and Federal standards for HEDIS . + Under general guidance form Senior Quality Practice Advisors and management,… more
    Centene Corporation (11/15/25)
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  • Quality Analyst (Quality Nurse )

    General Dynamics Information Technology (Falls Church, VA)
    …Infection Control and other quality measures. + Review raw and synthesized data ( HEDIS , ORYX, TJC, NPIC, NSQIP, AHRQ Measures, Carepoint, KSA, Mortality data etc.) ... **WHAT YOU'LL NEED TO SUCCEED:** + **Education** : Bachelor's Degree in a related field . + **Required Experience** : 2+ years of related data analytic experience. +… more
    General Dynamics Information Technology (11/18/25)
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  • Patient Care Advocate

    Centene Corporation (Lansing, MI)
    …providers at large IPA and/or group practices. Serves to collaborate with providers in the field , to improve HEDIS measures and provides education for HEDIS ... deficiencies impacting plan compliance to meeting State and Federal standards for HEDIS . Conducts telephonic outreach, while embedded in the providers' offices, to… more
    Centene Corporation (11/26/25)
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  • Provider Quality Liaison

    Centene Corporation (Austin, TX)
    …plan providers regarding quality initiatives and key quality performance indicators. Shares HEDIS , CAHPS, HOS, Part D and Administrative Operations reports and gap ... providers with existing resources to educate provider practices in appropriate HEDIS (Healthcare Effectiveness Data and Information Set) measures, medical record… more
    Centene Corporation (11/27/25)
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  • Provider Quality Liaison

    Centene Corporation (Little Rock, AR)
    …plan providers regarding quality initiatives and key quality performance indicators. Shares HEDIS , CAHPS, HOS, Part D and Administrative Operations reports and gap ... providers with existing resources to educate provider practices in appropriate HEDIS (Healthcare Effectiveness Data and Information Set) measures, medical record… more
    Centene Corporation (11/27/25)
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  • Value Based Case Management Senior Analyst - RN

    Health Care Service Corporation (Mobile, AL)
    …manage relationships with participating provider practices. Maintain detailed understanding of HEDIS / STAR performance measures. Develop and maintain a process to ... **Required Job Qualifications:** + Current Licensure as a registered nurse , in the state of residence in good standing....can be a combination of LVN/RN licensure) + Previous HEDIS and/or CMS STARs experience a plus. **Preferred Job… more
    Health Care Service Corporation (10/28/25)
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