- Providence (WA)
- **Description** The on-call HEDIS Clinical Audit Coordinator is responsible for conducting clinical quality audits for the Quality Department. The auditor ... season, which runs approximately February through mid-May. The RN auditor will successfully complete HEDIS training prior...**Required Qualifications:** + Degree in Nursing + Oregon Registered Nurse License + 5+ years clinical experience… more
- Providence (Lubbock, TX)
- …people, we must empower them._** **Providence Health Plan is calling a Coding Quality Auditor , HEDIS who will:** + Be responsible for conducting clinical ... Quality Department + Identify and reports issues related to clinical audits to determine potential areas for quality improvement...posting is for multiple openings of a Coding Quality Auditor , HEDIS ** + **This position is affiliated… more
- US Tech Solutions (Newark, NJ)
- …6+ months 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...trends and facilitate quality improvement initiatives. + Assist with clinical studies, quality projects, and audits. + Lead and… more
- Banner Health (AZ)
- …employment settings by including remote and hybrid opportunities. As a **Licensed Practical Nurse (LPN)** for **Banner Health Plans** , you will be an integral part ... . This assignment-based role focuses on independent chart review and clinical assessment. **Key Responsibilities** : + Independently review patient medical charts… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Ensuring all regulatory requirements are being met, such as NYS DOH, CMS, NCQA, and HEDIS , serving as internal auditor within the group. + Responsible for all ... drivers. Essential Accountabilities Level I + Handles physical health member clinical management programs. + Maintains knowledge of current Case Management Society… more
- CDPHP (Latham, NY)
- …Ensuring all regulatory requirements are being met, such as NYS DOH, CMS, NCQA, and HEDIS , serving as internal auditor within the group. + Responsible for all ... or external referral sources. Applies case management criteria and professional clinical judgment to determine a member's appropriateness for case management… more