- Humana (Tallahassee, FL)
- …reviews and supports the staff involved in HEDIS hybrid season review. The Quality Compliance Nurse works to gain more information about members ... caring community and help us put health first** The Quality Compliance Nurse helps in...your skills to make an impact** **Required Qualifications** + Registered Nurse ( RN ) license +… more
- Actalent (Orlando, FL)
- Actively Interviewing for HEDIS - Quality Improvement Abstractor to join health maintenance organization! Description: Position Purpose: Lead data collection and ... abstraction for company quality measures, including HEDIS , CMS, CHIPRA and/or...standards + Review medical records and abstract data for HEDIS and other measure sets in compliance … more
- Centene Corporation (Tallahassee, FL)
- …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
- Molina Healthcare (South Florida, FL)
- … compliance activities. **Candidates with experience in healthcare Quality / HEDIS metrics/Risk Adjustment will receive first consideration.** ... License ( RN may be preferred for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are… more
- CVS Health (Tampa, FL)
- …expense reimbursement policy. Preferred Qualifications : Oklahoma residency preferred Oklahoma-licensed registered nurse preferred OR be certified as a Certified ... full accountability for business/financial results related to following as appropriate: HEDIS reporting, quality of care, accreditation activities and/or member… more
- University of Miami (Miami, FL)
- …Providers supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of ... preferred + Completion of Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge… more
- Evolent Health (Tallahassee, FL)
- …+ 1-2 years of experience working with a global workforce and a working knowledge of clinical quality metrics such as HEDIS and NCQA preferred. + 2 - 4 years of ... results, and collaborating with others. **Collaboration Opportunities** : The Lead Nurse of Utilization Management is responsible for assisting the UM Manager… more