HEDIS Clinical Review Nurse, LVN 23-00273
Alura Workforce Solutions
Hedis Clinical Review Nurse, Lvn
Under the direction of the Clinical Quality Improvement (CQI) Supervisor, the HEDIS Clinical Review, LVN provides support to the CQI Supervisor, HEDIS Nurse RN, and other departments on HEDIS and quality improvement-related activities. This position maintains a working knowledge of the organization's current medical management policies and procedures.
Alura Workforce Solutions$91.25k - $120.91k
...resolution of case assignments Reviewing escalated issues Discussing... ...including, but not limited to, HEDIS, CAHPS, and NCQA... ...setting Bachelor's degree in Nursing from an accredited institution... ...Risk Management (CPHRM), or Clinical certification in area specialty...HEDISTemporary workWork experience placementRemote work- ...transition planning Review and revise... ...care team members (i.e. LVN Care Manager, Care Coordinator... ...identifying and addressing HEDIS gaps, and by... ...Qualifications: Minimum 2 years clinical experience in an acute care facility, skilled nursing facility, home health...HEDISFull timeWork experience placement
$63.9k - $83.08k
...The Grievance & Appeals Nurse is responsible for... ...including, but not limited to, HEDIS, CAHPS, and NCQA... ...Departments, and DMHC/DHS/CMS in reviewing grievance issues. #... ...and is a resource for clinical and non-clinical Team... ...Vocational Nurse (LVN) license issued by the...HEDISTemporary workImmediate startFlexible hours- ...incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Perks IEHP is not only committed... ...Experience leading succession planning and executive talent review processes Bachelor’s degree in Organizational Leadership, Human...HEDISTemporary workFlexible hours
$91.25k - $120.91k
...support, and implement assigned clinical quality and/or service... ...provider training/education, review/develop policy, and interpret... ...related to CMS Star Ratings, HEDIS, CAHPS, HOS, P4P, and other identified... ..., and unencumbered Registered Nurse (RN) license issued by the California...HEDISTemporary workWork at officeLocal areaFlexible hours- ...Position: Clinical Director - Psychiatric Nurse Practitioner Job Type: Part Time 20 hours/week - 5 Hours per day Job Summary The Clinical Director –... ...Quality Assurance and Operations Participate in complex case reviews and provide clinical perspective. Partner with external...Contract workPart timeReliefWork at officeWork from home
$104.04k - $137.84k
...incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP... ...Talent Strategy Build and refine succession planning and talent review protocols for executive and critical roles, including process...HEDISTemporary workRemote workFlexible hours$91.25k - $120.91k
...acute care hospitals, skilled nursing facilities, hospice agencies,... ...supporting, and implementing assigned clinical quality, and/or service... ...provider training/education, policy review/development, and regulatory/... ...Services (CMS) Star Ratings, HEDIS, CAHPS, HOS, P4P and other...HEDISTemporary workWork at officeLocal areaRemote workFlexible hours- ...UNIT Nurse Manager (RN/LVN) Department: Nursing Reports To: Director of Nursing Employment... ...Nurse Manager (RN or LVN) to provide clinical leadership and oversight for nursing... ...based on resident condition changes Review MARs/TARs, nursing notes, and admission...Shift work
- ...Service Plan (SP), and maintaining clinical quality while leading and... ...prepare for regulatory surveys. Reviews Physician Reports of all new... ...of approved college/school of nursing. Maintains a current state... ...Vocational Nurse (LPN/LVN). Minimum of one (1) year experience...Work at officeLocal areaImmediate startFlexible hoursShift workNight shiftWeekend workDay shiftAfternoon shift
- ...Refinancing Pet Insurance Employee Assistance Program The Wellness Nurse is a licensed nurse responsible for coordinating resident care... ...basis according to company policy and state regulations. Review and monitor staff use of the Shift Report daily and participate...RelocationShift work
- ...Hedis Improvement Registered Nurse Position HEDIS Improvement Registered Nurse Description Under the direction of the Supervisor, Clinical Quality Improvement, the HEDIS Improvement Nurse provides support to the Supervisor, Clinical Quality Improvement and company departments...HEDIS
- ...functions including user account provisioning/deprovisioning, access reviews and risk assessments, investigating and resolving IAM related... ...IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Perks IEHP is not only committed...HEDISTemporary workWork experience placementFlexible hours
$118.6k - $157.14k
...incorporating IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Perks Competitive salary Hybrid... ...development life cycle (SDLC), including coding standards, code reviews, source control management, build processes, testing, and...HEDISTemporary workFlexible hours$154.13k - $204.21k
...incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP... ..., while monitoring and evaluating outcomes. Conduct performance reviews of each team Member within IEHP guidelines. Perform any other...HEDISTemporary workWork experience placementWork at officeRemote workMonday to FridayFlexible hours$118.6k - $157.14k
...incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP... ..., while monitoring and evaluating outcomes. Conduct performance reviews of each team Member within IEHP guidelines. Perform any other...HEDISContract workTemporary workWork at officeRemote workMonday to FridayFlexible hours- ...operational strategies by completing compliance assessments, regulatory reviews and audit related submissions; managing cross-functional... ...incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Perks Competitive salary State...HEDISTemporary workWork at officeLocal areaFlexible hours
$220.04k - $302.54k
...including, but not limited to, HEDIS, CAHPS, and NCQA... ...with executive teams from all clinical and non-clinical areas to execute... ..., assigning, scheduling, and reviewing work, ensuring quality standards... ...required : Registered Nurse (RN) license issued by the California...HEDISTemporary workRemote workFlexible hours$30.72 per hour
...Grievance and Appeals Nurse (LVN) Position Type: Full-time Schedule: (Hybrid) M-F, 8:... ...Services Departments, and DMHC/Client/CMS in reviewing grievance issues. # Review case coding... ...and appeals and is a resource for clinical and non-clinical Team Members in expediting...Full timeImmediate startWork from home- ...Temporary Grievance & Appeals Nurse (LVN) The position is 100% remote, and the candidates... ...member outcomes. The nurse also serves as a clinical subject matter expert, providing... ...internal teams to ensure continuity of care Review and investigate member grievances,...Temporary workWork at officeImmediate startRemote work
$25.9 - $33.02 per hour
...incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP... ...meetings, training sessions, outbound campaigns, and coaching. Review and monitor non-phone-related activities such as time-off...HEDISTemporary workRemote workFlexible hours$80.06k - $106.06k
...operational strategies by completing compliance assessments, regulatory reviews, audit‑related submissions, managing cross‑functional regulatory... ...IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits...HEDISTemporary workWork at officeLocal areaRemote workFlexible hours$154.13k - $204.21k
...incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits... ..., while monitoring and evaluating outcomes. Conduct performance reviews of each team Member within IEHP guidelines. # Perform any other...HEDISTemporary workRemote workMonday to FridayFlexible hours$280.84k - $393.18k
...oversight of IEHP Medical Policies and clinical leadership around member health outcomes... ...Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.... ...Manage medical directors, as well physician reviewers, working in the domains of policy, outcomes...HEDISTemporary workLocal areaRemote workFlexible hours$135.2k - $179.13k
...incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks... ...IT Strategic Programs / leadership meetings where projects are reviewed and assessed by IT leadership. # Assist the work with...HEDISTemporary workWork experience placementRemote workMonday to FridayFlexible hours$118.6k - $157.14k
...incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks... ...protocols, ensuring replication of results by an independent reviewer. Demonstrate a commitment to incorporate LEAN principles into...HEDISTemporary workWork experience placementWork at officeRemote workMonday to FridayFlexible hours- Ivy Park at Otay Ranch in Rancho Cucamonga, California, is seeking a Wellness Nurse to coordinate resident care and manage medication under medical supervision. This role is crucial in ensuring that residents maintain their independence and receive quality health support...
- Inland-Empire-Health-Plan- is seeking a Quality Improvement RN in Rancho Cucamonga, CA. This role involves facilitating quality initiatives to enhance health care delivery and improve performance metrics. Candidates should possess a Bachelor's in health-related fields and...HEDISRemote work
$91.25k - $120.91k
...experiences. Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Education & Requirements At least five (5) years of progressive experience in Learning & Development...HEDISTemporary workFlexible hours- ...Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Perks IEHP is not... ...Education & Requirements Minimum two (2) years clinical experience in an acute care facility, skilled nursing facility, home health or clinic setting required Two...HEDISTemporary workRemote workFlexible hours
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