• Sr. Specialist, Member & Community Intervention…

    Molina Healthcare (El Paso, TX)
    …+ Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested ... & Community Interventions oversees and implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare,… more
    Molina Healthcare (08/24/25)
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  • Quality Practice Advisor (BH)

    Centene Corporation (Indianapolis, IN)
    …providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides ... compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for...maintains provider clinical relationship across product lines. + Maintains Quality KPI and maintains good standing with HEDIS more
    Centene Corporation (08/08/25)
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  • Quality Improvement Supervisor, Clinical

    CenterWell (Port St. Lucie, FL)
    …excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in applicable state + ... scope of provider relationships across the following areas: + Quality /clinical management and population health + HEDIS ...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    CenterWell (08/08/25)
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  • Senior Quality Compliance

    Humana (Indianapolis, IN)
    …a part of our caring community and help us put health first** The Senior Quality Compliance Professional completes annual quality reviews and research. The ... Senior Quality Compliance Professional work assignments involve moderately complex to complex...improving consumer experiences Must reside in Indiana Preferred Qualifications Quality HEDIS GAP closure experience Applicable State… more
    Humana (09/09/25)
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  • Quality Management, Nurse Consultant

    CVS Health (Oklahoma City, OK)
    …3 years experience in clinical, managed care, or health related field. - State of Oklahoma Registered Nurse ( RN ) license in the state of their residence. - ... And we do it all with heart, each and every day. **Position Summary** The Quality Management, Nurse Consultant has a key role in developing and implementing… more
    CVS Health (09/06/25)
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  • Manager Integrated Case Mgmt-SCMG…

    Sharp HealthCare (San Diego, CA)
    …California Registered Nurse ( RN ) - CA Board of Registered Nursing; Certified Professional in Healthcare Quality (CPHQ) - National Association for ... Or + Bachelor's Degree in Healthcare Administration. + California Registered Nurse ( RN ) - CA...basis.Collaborates with SCMG Management and HSM Management staff in quality related activates to ensure compliance with… more
    Sharp HealthCare (08/29/25)
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  • Quality Management Clinical Nurse

    UCLA Health (Los Angeles, CA)
    Description The Quality Management Nurse is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare ... involves evaluation clinical practices, identifying areas for improvement, and implementing quality improvement initiatives to enhance patient care and safety. In… more
    UCLA Health (07/14/25)
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  • CIC Advanced Practice Clinician - NP / PA - Hybrid

    Commonwealth Care Alliance (Springfield, MA)
    …as NP or PA in primary care or care management AND 3+ years' experience as Registered Nurse or EMT-P in a high touch clinical environment or home care; OR ... that a defined panel of patients receive the highest quality , community-based skilled care within the context of a...or PA graduate, must have 5+ years' experience as Registered Nurse or EMT-P in a high… more
    Commonwealth Care Alliance (07/09/25)
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  • Epic Training Analyst II

    AdventHealth (Woodridge, IL)
    …valid drivers license and reliable form of transportation. EPIC Credential (EPIC CRED) preferred Registered Nurse ( RN ) preferred This facility is an equal ... of quality reporting and physician practice regulatory programs (eg, HEDIS , MIPS). Displays advanced knowledge and skills necessary to deliver quality more
    AdventHealth (08/07/25)
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  • Manager, Care Management

    Humana (Springfield, IL)
    …+ **Must reside in the state of Illinois** + An active, unrestricted, Registered Nurse **( RN )** license, Licensed Clinical Social Worker **(LCSW)** ... Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics and to...mentoring and coaching associates. + Prior experience with healthcare quality measures STARS, HEDIS , etc. and/or clinical… more
    Humana (08/29/25)
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