- Molina Healthcare (Ridgeland, MS)
- …EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + Minimum 10 years experience in quality compliance / HEDIS operations, customer service or provider service ... **Job Description** **Job Summary** The AVP, Quality & Risk Adjustment is responsible for leading...plan and executes on interventions that will improve CAHPS, HEDIS and HOS scores. Responsible for monitoring Part D… more
- US Tech Solutions (Newark, NJ)
- …contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state ... audits, HEDIS measures, and quality -related complaints and referrals. + This role also supports...preferably in the healthcare industry. + **Active New Jersey Registered Nurse ( RN ) License required.**… more
- Molina Healthcare (Omaha, NE)
- …setting is important skill set. **Required Experience** 3 - 5 years in quality compliance / HEDIS operations, customer service or provider service in ... the implementation of NCQA accreditation surveys and federal QI compliance activities. The Quality AVP will be...of Care (PQOC) issues locally. Must be state licensed RN , Physician, PA or CPHQ certified. **WORK LOCATION** -… more
- Centene Corporation (Springfield, IL)
- …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
- Martin's Point Health Care (Portland, ME)
- …bodies. + Maintains detailed project documentation in accordance with the NCQA HEDIS technical specifications, and HEDIS compliance audit standards, ... minimum of five (5) years of experience in the health care industry, in HEDIS and/or quality improvement. + Experience in managed care health services… more
- Elevance Health (Hialeah, FL)
- ** HEDIS Medical Records Review Project Nurse **... quality reviewer processes. + Conducts over-reads on HEDIS records for compliance against HEDIS ... considered for employment, unless an accommodation is granted as required by law._ The ** HEDIS Medical Records Review Project Nurse ** is responsible for HEDIS… more
- Molina Healthcare (OH)
- …+ Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested ... maintain critical program milestones, deadlines, and/or deliverables + Participates in quality / HEDIS improvement activities, meetings, and discussions with and… more
- Molina Healthcare (OH)
- …+ Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested ... within the department and/or collaboratively with other departments. Please include any HEDIS / Quality experience on your resume. This experience is important for… more
- InGenesis (Fremont, CA)
- InGenesis is seeking an Urgent Care Registered Nurse to join our team in support of our client. In this essential role, you will collaborate with physicians and ... care for a diverse, often underserved population. As an urgent care registered nurse and physician extender, you'll assess symptoms, coordinate care,… more
- CenterWell (Lutz, FL)
- …experience, provider experience and operational excellence **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in applicable ... + Proven work experience as a HEDIS Nurse or similar role in healthcare quality ...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction… more