- University of Southern California (Alhambra, CA)
- …InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Required Licenses/Certifications: + Req Registered Nurse - RN (CA DCA) + Req Basic ... services required to meet an individual's health care needs to promote cost-effective, quality outcomes. Serves as a consultant to members of the health care team… more
- UCLA Health (Los Angeles, CA)
- Description The Quality Management Nurse is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare standards ... involves evaluation clinical practices, identifying areas for improvement, and implementing quality improvement initiatives to enhance patient care and safety. In… more
- Banner Health (AZ)
- …and High Volume Specialists (HVS). This position is also responsible for assisting the QM RN with the investigation and research of quality of care concerns that ... **Department Name:** Banner Staffing Services-AZ **Work Shift:** Day **Job Category:** Risk, Quality and Safety **Estimated Pay Range:** $26.40 - $44.00 / hour,… more
- Fallon Health (Barnstable, MA)
- …care related field preferred. **License** : Active, unrestricted license as a Registered Nurse in Massachusetts **Certification** : Certification in Case ... and reliable transportation **Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members or experience in a… 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 Health** at Barksdale AFB, LA. Apply online… more
- Centene Corporation (Lansing, MI)
- …Social Work (LMSW); Certified Social Worker (C-SW); Licensed Social Worker (LSW); Licensed Registered Nurse ( RN ).** **Candidates must be located in ... HEDIS measures and coding. Supports the implementation of quality improvement interventions and audits in relation to plan...Certified Social Worker (C-SW); Licensed Social Worker (LSW); Licensed Registered Nurse ( RN ) preferred. Pay… 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
- CVS Health (Columbia, SC)
- …products and VPN. **Preferred Qualifications:** + Licensed Allied Health Professional or Licensed Registered Nurse + Coding or Sales background + Certified Six ... it all with heart, each and every day. The Quality Practice Transformation Advisor plays a critical role in...+ 2+ years of process improvement experience related to HEDIS measures. + In-depth knowledge of healthcare regulations, clinical… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …(CPHQ) or Certification in Health Care Quality and Manager (CHQM) * Registered Nurse * Solid knowledge of Medicare Advantage Business Compensation and ... are in-house subject matter experts on coding accuracy and Quality programs such as including HEDIS and Stars. Your Responsibilities As part of a Blue… 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 ... KC tools and incentive programs focused on improving the quality of care for Medicare Advantage & Qualified Health...data and monitor provider metrics to identify risk adjustment, HEDIS or educational opportunities for the Medicare Advantage and… more