- CenterWell (Indianapolis, IN)
- …you'll be part of a collaborative, multidisciplinary team that includes nurse practitioners, pharmacists, care coaches, behavioral health specialists, and more-all ... environment + Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality indicators **Compensation & Benefits** + Competitive base salary + annual… more
- ChenMed (Pembroke Pines, FL)
- …and execution of business strategies that increase revenue and quality ratings ( HEDIS /STARS/Clinical Gaps) and support our core model. + Develops protocols and ... healthcare related field preferred + Active and good standing Licensed Practical Nurse (LPN) in current state of employment **OR** a nationally accredited Certified… more
- Molina Healthcare (Ann Arbor, MI)
- …Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review, and manages the denial ... policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS , Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice,… more
- University of Rochester (Rochester, NY)
- …Primary Care. **MINIMUM EDUCATION & EXPERIENCE** + Bachelor degree Required + Registered Nurse (RN) Preferred + 5 years of experience in health care setting Required ... for submission of PCMH. + Participate in reviewing reports to ensure alignment with HEDIS and CMS metric definitions to meet PCMH requirements. + Works closely with… more
- Centene Corporation (Austin, TX)
- …Thorough knowledge Medicare and Medicaid quality scoring methodologies including HEDIS , NCQA and Pay-for-Performance Measures:** Required Other Thorough knowledge of ... A license in one of the following is required: Required Registered Nurse (RN)Pay Range: $68,700.00 - $123,700.00 per year Centene offers a comprehensive… more
- Queen's Health System (Kamuela, HI)
- …**CERTIFICATION AND LICENSURE:** * Current Hawaii State license as a Registered Nurse . **EXPERIENCE:** * Three (3) years nursing experience in an acute care ... health care regulatory and clinical quality measurements frameworks such as NCQA HEDIS , Meaningful Use, PQRS, OPPE, CORE measures, etc. preferred. * Experience with,… more
- Mount Sinai Health System (New York, NY)
- …Medicare regulations and related reporting requirements, such as STARS,QARR, MMCOR, MEDS, RAPS and HEDIS is a strong plus. + Experience working in a health plan or ... or medical economics departments highly valuable. + Experience as a nurse informaticist highly valuable. + Experience working in healthcare provider analytics… more
- Veterans Affairs, Veterans Health Administration (Chesapeake, VA)
- …(CTM), recall delinquency report, secure messages, VeTEXT, VAR, as well as SAIL/ HEDIS metrics that directly impact the PACT team's metrics for patient care. Other ... of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical… more
- Molina Healthcare (Layton, UT)
- …Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review, and manages the denial ... policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS , Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice,… more
- Humana (Springfield, IL)
- …reside in the state of Illinois** + An active, unrestricted, Registered Nurse **(RN)** license, Licensed Clinical Social Worker **(LCSW)** **OR** Licensed Clinical ... coaching associates. + Prior experience with healthcare quality measures STARS, HEDIS , etc. and/or clinical program monitoring/evaluation. + Knowledge of community… more