• HEDIS Registered Nurse

    Insight Global (Philadelphia, PA)
    Job Description A client of Insight Globals is looking for HEDIS RNs or LPNs for a partially remote contract position in PA and NJ. PARTIALLY remote position as it ... abstraction & entry of medical records assigned by a Clinical Quality Lead nurse . Miles will be reimbursed for any travel. Computer equipment, encrypted zip drives… more
    Insight Global (04/01/25)
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  • Patient Care Advocate

    Centene Corporation (Little Rock, AR)
    …Social Work (LMSW); Certified Social Worker (C-SW); Licensed Social Worker (LSW); Licensed Registered Nurse ( RN ) preferred.Pay Range: $26.50 - $47.59 per ... IPA and/or group practices. Serves to collaborate with providers in the field , to improve HEDIS measures and provides education for HEDIS measures and… more
    Centene Corporation (04/27/25)
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  • RN Care Coordinator II

    Covenant Health Inc. (Knoxville, TN)
    Overview Registered Nurse Care Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Occasional travel as needed Covenant Medical Group ... coordination services within the scope of practice as a registered nurse meeting all required standards both...or CPHQ OR Bachelors degree in Nursing or related field . Apply/Share Job Title RN CARE COORDINATOR… more
    Covenant Health Inc. (04/24/25)
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  • Care Manager/Population Health RN

    Centene Corporation (Harrisburg, PA)
    …Bachelor's degree in Nursing and 2 - 4 years of related experience. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact State ... and increase quality outcomes with care gap closures and HEDIS measures. After successful implementation, goals would be to...and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be… more
    Centene Corporation (05/04/25)
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  • Case Manager, RN or Licensed Behavioral…

    Excellus BlueCross BlueShield (Rochester, NY)
    …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... All Levels + Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist licensure required; or LMSW;… more
    Excellus BlueCross BlueShield (05/01/25)
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  • Manager, Clinical Quality Interventions…

    Molina Healthcare (Phoenix, AZ)
    …strategic team to present and evaluate intervention strategies. **Only individuals with an RN license are being considered at this time.** + Plans and/or implements ... health care providers. **JOB QUALIFICATIONS** **Required Education** Active, unrestricted RN License. **Required Experience** 5+ years' experience in managed… more
    Molina Healthcare (04/25/25)
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  • LPN/ RN Clinical Manager

    ChenMed (Maple Heights, OH)
    …and execution of business strategies that increase revenue and quality ratings ( HEDIS /STARS/Clinical Gaps) and support our core model. + Develops protocols and ... in Business or Healthcare Administration or a healthcare related field preferred + Active and good standing Licensed Practical... preferred + Active and good standing Licensed Practical Nurse (LPN) in current state of employment **OR** a… more
    ChenMed (04/24/25)
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  • Quality Practice Advisor - Medical Affairs

    Centene Corporation (Houston, TX)
    …benefits including a fresh perspective on workplace flexibility. **Applicants with HEDIS measures and Medicare STAR Ratings experience** **Work Location: Houston, ... sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for ...and risk adjustment required. **One of the following required:** RN , APRN, HCQM, CHP, CPHQ, CPC, CBCS, CCS, LPN,… more
    Centene Corporation (04/27/25)
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  • Quality Practice Advisor

    Centene Corporation (Oklahoma City, OK)
    …- FRIDAY, 8AM - 5PM CENTRAL TIME ZONE. IDEAL APPLICANT WILL BE A NURSE WITH HEDIS BACKGROUND.** **Position Purpose:** Establishes and fosters a healthy working ... sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for ...following required:** CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN , APRN, HCQM, CHP, CPHQ, CPC, CBCS required Pay… more
    Centene Corporation (04/16/25)
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  • Community Care Nurse Case Manager - Hybrid

    Fallon Health (Worcester, MA)
    field preferred. **License** : Active, unrestricted license as a Registered Nurse in Massachusetts **Certification** : Certification in Case Management ... policies and processes o Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member...**Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
    Fallon Health (04/16/25)
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