- Fallon Health (Barnstable, MA)
- …care related field preferred. **License** : Active, unrestricted license as a Registered Nurse in Massachusetts **Certification** : Certification in Case ... Fallon Health Pharmacist, referring members in need of medication review based upon Program process o Develops and fosters...**Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
- ERP International (Barksdale AFB, LA)
- …NP experience after graduation Licensure:** Current, full, active, and unrestricted Registered Nurse license Life Support Certification:** Possess current ARC ... **Overview** ERP International is seeking a ** Nurse Practitioner,** for a Full-Time position supporting **Occupational...deployment status in a private setting. + Conduct pre-deployment review of health record for any conditions that may… more
- Centene Corporation (Lansing, MI)
- …Licensed Marital and Family Therapist (LMFT), Licensed Certified Social Worker (LCSW), Licensed Registered Nurse ( RN ), Acute Care Nurse Practitioner ... field or equivalent work experience within a managed care environment related to HEDIS record review , quality improvement, medical coding or transferable skill… more
- Insight Global (Austin, TX)
- …* 1+ yr in care management/ HEDIS /Stars, women's health, or imaging navigation * Active Registered Nurse ( RN ) Compact License and RN License in one ... new program that reviews health risk assessments and supports HEDIS gap closure. In this role, you will conduct...* Minimum of 2+ years' experience working as a Registered Nurse , * 1+ year of experience… more
- Molina Healthcare (Fort Worth, TX)
- …education and experience. * At least 7 years health care management/leadership experience. * Registered Nurse ( RN ), Licensed Vocational Nurse (LVN), ... Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse ( RN ). License must be active and… more
- Blue KC (Kansas City, MO)
- …+ Experience working for a health plan and/or within a provider office + Registered Nurse and/or medical licensure + Knowledge base of clinical standards of ... experts; and influence provider behavior to achieve needed results. The person will review charts, identify gaps in care, and educate providers and offices to ensure… more
- CareFirst (Baltimore, MD)
- …addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + Health Services\ RN - Registered Nurse - State Licensure and/or ... partnering hospital. This role will assist leadership with the development and review of Care Management standards, program criteria, policies, and procedures to… more
- University of Miami (Miami, FL)
- …Providers supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of ... Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and...Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge of Hierarchical Condition… more
- CDPHP (Latham, NY)
- …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources.… more
- CenterWell (Atlanta, GA)
- …to the strategic intent Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA) in: ... inquiries, requests, and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality...Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice… more