• HEDIS RN - Quality…

    US Tech Solutions (Newark, NJ)
    …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
    US Tech Solutions (08/22/25)
    - Related Jobs

  • Senior Overreader, HEDIS / Quality…

    Molina Healthcare (NE)
    …assist with ad hoc projects. **Job Duties** + Performs the role of the HEDIS medical record review overreader/ auditor which includes ongoing review of records ... Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS...**O** **C** **I** **A** **TI** **O** **N** **:** Active RN license for the State(s) of employment **PHY** **S**… more
    Molina Healthcare (08/21/25)
    - Related Jobs

  • Director, Clinical Data Acquisition ( HEDIS…

    Molina Healthcare (St. Petersburg, FL)
    …outreach. + Serves as operations subject matter expert and lead for Molina Plan quality improvement HEDIS operations using a defined roadmap, timeline and key ... equivalent). **PREFERRED EXPERIENCE:** * 10+ years' experience with member/ provider ( HEDIS ) outreach and/or quality intervention or improvement studies… more
    Molina Healthcare (08/21/25)
    - Related Jobs

  • Case Manager, RN or Licensed Behavioral…

    Excellus BlueCross BlueShield (Dewitt, NY)
    …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... health care services. Examples may include: Utilization Management, Quality , Behavioral Health, Pharmacy, Registered Dietitian and...being met, such as NYS DOH, CMS, NCQA, and HEDIS , serving as internal auditor within the… more
    Excellus BlueCross BlueShield (08/28/25)
    - Related Jobs

  • Sr. Specialist, Member & Community Intervention…

    Molina Healthcare (El Paso, TX)
    …Experience with data reporting, analysis, and/or interpretation + Certified Professional in Health Quality (CPHQ) + Nursing License ( RN may be preferred for ... Community Interventions oversees and implements new and existing clinical quality member intervention initiatives including all lines of business...specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current… more
    Molina Healthcare (08/24/25)
    - Related Jobs

  • Specialist, Member & Community Interventions…

    Molina Healthcare (Owensboro, KY)
    …experience in Medicare and in Medicaid managed care + Certified Professional in Health Quality (CPHQ) + Nursing License ( RN may be preferred for specific roles) ... Member & Community Interventions implements new and existing clinical quality member intervention initiatives including all lines of business...+ Certified HEDIS Compliance Auditor (CHCA) + Certified Community… more
    Molina Healthcare (09/07/25)
    - Related Jobs