• Quality Program Strategist II

    Centene Corporation (Raleigh, NC)
    …health insurance experience required; 2+ years of quality experience preferred. **License/Certification:** Registered Nurse ( RN ), Licensed Practical Nurse ... market trends and oversee functions of quality improvement programs for HEDIS , CAHPS, and/or HOS strategy and related quality improvement activities. Assists… more
    Centene Corporation (07/26/25)
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  • Program Director, Quality Improvement (Remote)

    Molina Healthcare (Davenport, IA)
    …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
    Molina Healthcare (08/02/25)
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  • Quality Management Clinician

    UPMC (Media, PA)
    …of Quality Management. + Responsible for professional and staff development plan. + Licensed Registered Nurse (BSN is a bonus) or Masters Degree (licensure is a ... a combination of time in the office, in the field at provider sites, and working remotely from home....to quality management and improvement in compliance with NCQA, HEDIS , URAC, and the Commonwealth of Pennsylvania Department of… more
    UPMC (07/17/25)
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  • Practice Transformation Associate

    CVS Health (Tallahassee, FL)
    …And we do it all with heart, each and every day. **This is a Field based role requiring 50% travel with in the state of Florida.** The Practice Transformation ... work both internally and externally with some travel time in the field to assigned provider offices. **Required Qualifications** + Bachelor's degree in healthcare… more
    CVS Health (07/12/25)
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  • Director, Quality Improvement

    Humana (Madison, WI)
    …confidentiality. **Use your skills to make an impact** **Required Qualifications** + Registered Nurse ( RN ), physician or physician's assistant licensed ... the bar for excellence. Key responsibilities include: + Oversees HEDIS , CAHPS, Star ratings, and other State-required measure reporting...from date of hire. + Bachelor's degree in a field related to healthcare quality. These fields may include,… more
    Humana (07/29/25)
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  • Quality Management, Nurse Consultant

    CVS Health (Oklahoma City, OK)
    …experience in clinical, managed care, or health related field . - State of Oklahoma Registered Nurse ( RN ) license in the state of their residence. - ... with heart, each and every day. **Position Summary** The Quality Management, Nurse Consultant has a key role in developing and implementing data-driven… more
    CVS Health (08/01/25)
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  • Clinical Documentation Integrity Specialist…

    UCLA Health (Los Angeles, CA)
    …work effectively with common office software, coding software, and EMR systems, required + Registered Nurse ( RN ) or clinical qualifications a plus + ... HCPCS coding systems required + Knowledge of Medicare Advantage STARS/ HEDIS program and NCQA technical specifications, required + Six...Bachelor's degree (healthcare or relevant field ) or equivalent experience/training Note: Skills may be subject… more
    UCLA Health (05/16/25)
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  • APP, Supervisor - General Internal Medicine - Full…

    University of Miami (Miami, FL)
    …Providers supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of ... + Completion of Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge of… more
    University of Miami (06/16/25)
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  • Quality Practice Transformation Advisor

    CVS Health (Lansing, MI)
    …products and VPN. **Preferred Qualifications:** + Licensed Allied Health Professional or Licensed Registered Nurse + Coding or Sales background + Certified Six ... a related role. + 2+ years Process Improvement experience related to HEDIS measures + In-depth knowledge of healthcare regulations, clinical operations, quality… more
    CVS Health (07/09/25)
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  • Senior Network Performance Professional

    Humana (Little Rock, AR)
    …impact** **Required Qualifications** + Bachelor's Degree in Business, Finance, Health Care/Administration, RN or a related field , or equivalent work experience + ... Time Zone) **Preferred Qualifications** + Master's Degree in Business, Finance, Health Care/Administration, RN or a related field + Experience with Medicare Risk… more
    Humana (08/08/25)
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