- Community Health Systems (Naples, FL)
- **Job Summary** Under the direction of the UR Director/Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical condition ... BSN required + 2-4 years clinical practice experience required + Experience in HEDIS , MIPS, PQRS, ACO, STARS preferred **Knowledge, Skills and Abilities** + Ability… more
- Adelante (Goodyear, AZ)
- Registered Nurse (Family/Internal Medicine) - Goodyear, AZ Job Details Job Location Adelante Healthcare Goodyear - Goodyear, AZ Position Type Full Time Job Category ... Health Care Description POSITION SUMMARY The Registered Nurse (RN) will play a pivotal role in guiding...and closure of Healthcare Effectiveness Data & Information Set ( HEDIS ) care gaps of required Quality Metrics. + Coordinate… more
- Centene Corporation (Spring Hill, FL)
- …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 (Raleigh, NC)
- …market trends and oversee functions of quality improvement programs for HEDIS , CAHPS, and/or HOS strategy and related quality improvement activities. Assists ... conclusions to determine appropriate solutions. + Conduct evaluations to assist with HEDIS gap closure, CAHPS and/or HOS performance and assess for potential pilot… more
- LifePoint Health (Ishpeming, MI)
- …(NCQA) structure and standards, Health Plan Employer Data and Information Set ( HEDIS ). Knowledge of how to use computerized statistical methods in CQI context. ... process management initiatives. Skill in consistently meeting requirements of NCQA, HEDIS and other regulators and accreditors. Skill in using computer capabilities… more
- Humana (Stuart, FL)
- …establish working relationships + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial performance ... **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN) without restriction in applicable state** + 5+ years of clinical… more
- Praxis Health (Portland, OR)
- …+ Coordinate with centralized PXH/Regence teams to drive performance in: + HEDIS metric tracking + Transitional Care Management (TCM) + Annual Wellness Visit ... Required Education + High school diploma + Licensed Practical Nurse (LPN) or Highly Skilled MA + Basic Healthcare...Experience + Population health program involvement or leadership + HEDIS metrics tracking and improvement + Outpatient primary care… more
- UPMC (Media, PA)
- …functions related to quality management and improvement in compliance with NCQA, HEDIS , URAC, and the Commonwealth of Pennsylvania Department of Health quality ... Management. + Responsible for professional and staff development plan. + Licensed Registered Nurse (BSN is a bonus) or Masters Degree (licensure is a bonus). +… more
- CenterWell (New Albany, IN)
- …Primary Care Organization. Integrated care teams that include physicians, nurse practitioners, medical assistants, medical coders and center administrators. Nearly ... (EHR) and electronic medical record (EMR) systems, including documentation of HEDIS and Stars quality measures + Maintain established quality control standards… more
- CenterWell (North Las Vegas, NV)
- …focused on teamwork and providing a positive and welcoming environment for all. The Nurse Practitioner (NP) works in our team-based care environment. We are a value ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more