Remote RN - Quality Program & Site Review (HEDIS)

Inland-Empire-Health-Plan-

Remote job

Inland Empire Health Plan (IEHP) seeks a Quality Program Nurse to implement and monitor quality management policies under the DHCS framework. Responsibilities include site reviews, medical record surveys, CAP oversight, and HEDIS data abstraction. The role requires CA RN licensure, CSR certification or willingness to obtain it, and collaboration across QM teams. Remote work is allowed with periodic on-site meetings and potential Inland Empire travel. #J-18808-Ljbffr Inland-Empire-Health-Plan-

Apply

Vacancy posted 4 days ago

Similar jobs that could be interesting for youBased on the Remote RN - Quality Program & Site Review (HEDIS) in California, MO vacancy

Quality Program Nurse, RN (Remote with field work)
...direction of the Manager, Quality Management Nurses, Quality Program Nurses (QPN) are... ...as pertaining to Facility Site Review (FSR) and Medical Record... ...including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation... ...Registered Nurse (RN) license issued by the California...
Remote job
HEDIS
Quality
Website
Temporary work
Flexible hours
Inland Empire Health Plans
California, MO
2 days ago
RN
$42 - $65 per hour
...ambulatory setting. The RN provides clinical... ...the highest quality of patient care by... ...purpose of visit and reviews charts for recent visits... ...specimens for on-site and remote-site testing. Tracks... ....Participates in Hedis, GPRO, and other quality programs as neededEnters provider...
Remote work
HEDIS
Quality
Website
Work at office
Catholic Health Service
Medford, NY
1 day ago
Utilization Reviewer
...Description Job Description Remote but must be able to get... ...for conducting quality audits for state audits, HEDIS and quality referral and... ...Responsibilities: 1. Conducts on-site/virtual reviews at participating... ...and vendors on programs and audit standards, both...
Remote work
HEDIS
Quality
Website
Winston Medical Staffing
Newark, NJ
4 days ago
RN Population Health Primary Care Clinics
RN Population Health Primary Care Clinics... ...assist with chart reviews, risk adjustment... ...(this role is 90% remote and 10% in-person... ...85629 Additional sites outside of this list... ...s Risk Adjustment program goals. This position... ...adjustment, HCCs, HEDIS quality Rate, etc.) This...
Remote work
HEDIS
Quality
Website
Full time
Local area
Monday to Friday
Shift work
Banner Health
Phoenix, AZ
1 day ago
ECM RN Care Manager
ECM RN Care ManagerJob DescriptionReports... .../Location:Remote / HybridFLSA Classification... ...across the program.Essential Duties... ...Care Plans.CHA Reviews: Review... ...engagement, and quality metrics to improve... ...Understanding of HEDIS measures, care gap... ..., conferences, site visits, or stakeholder...
Remote work
HEDIS
Quality
Website
Contract work
Work at office
Flexible hours
Symba-Center
Victorville, CA
2 days ago
HEDIS Review Nurse - Remote - Contract
...Review NurseThis is a contract assignment that will... ...Data and Information Set (HEDIS) survey. The review... ...the HEDIS surveyPerform quality reviews of abstracted medical... ...Integrity, Compliance Program policies and other... ...Requirements:Registered Nurse (RN)/ Licensed Practical...
Remote work
HEDIS
Quality
Contract work
Immediate start
HireOps Staffing LLC
Dallas, TX
4 days ago
Utilization Review Nurse RN
$40.12 - $62.19 per hour
...Utilization Review RNSinai Hospital's Utilization... ...or improving quality of care.Summary: Conducts... ...is a Full-time remote position.Responsibilities... ...Utilization Review RN reviews the medical... ...into the software program. Maintains close... ..., and free on-site parkingAbout Sinai...
Remote work
Quality
Website
Full time
LifeBridge Health
Owings Mills, MD
1 day ago
Utilization Review RN
$51.43 - $79.84 per hour
...Description – This is a remote role. You MUST live... .... Care Manager RN, Per diem / On call... ...The Utilization Review (UR) Nurse has a strong... ...supports the UM program by developing and maintaining... ...access to quality health care for all... ...Type: On-site Pay Range: $51....
Remote work
Quality
Website
Daily paid
Live in
Shift work
Day shift
Providence Swedish Medical Center
Seattle, WA
3 days ago
RN Coordinator Home Visiting Program
...(GLFHC) is a multi-site mission-driven non-... ...providing the highest quality patient care to... ...Medicine Residency Program. GLFHC is currently seeking an RN Coordinator – Home... ...Reconcile medications, review discharge... ...skills and comfort with remote patient management....
Remote work
Quality
Website
GLFHC
Lawrence, MA
4 days ago
Clinical Claim Review RN
$29 - $52 per hour
...Program Integrity Clinical Compliance AuditorOptum... ...risk management, quality and revenue growth.... ...compliance reviews of medical and administrative... ...will conduct site visits and desk audits... ....This position is Remote in Massachusetts. You... ...licensure (RN or LPN) with a current...
Remote work
Quality
Website
Hourly pay
Minimum wage
Full time
Contract work
Work experience placement
Live in
Local area
Monday to Friday
Shift work
UMR
Boston, MA
2 days ago
Utilization Management Reviewer (RN) - Multiple Positions!
...Medical Director for review. Refer to and work... ..., or on-site, depending on customer... ...and refers potential quality of care and utilization... ...interacts with Health Plan programs and services.... ...and active NYS RN license required. Bachelors... ...be opportunity for remote work within all...
Remote work
Quality
Website
Contract work
Work at office
Excellus BCBS
Jamestown, NY
1 day ago
Registered Nurse Program Coordinator Ortho Operating Room
$45.31 - $67.01 per hour
...Job Description: The RN Program Coordinator is a hospital or care site level leader who provides... ...to the development and review of care protocols, policies... ...clinical outcomes and quality of care, and outlines... ...expectations. If applying for a remote or hybrid role, this...
Remote work
Quality
Website
Hourly pay
Full time
Shift work
Intermountain Health
Evergreen, CO
7 days ago
Remote Clinical Quality Program Lead
Elevance Health is seeking a Clinical Quality Program Manager to lead quality improvement initiatives across state programs. You will partner with analytics and cross-functional teams to drive HEDIS performance, ensure robust study methodology, and oversee implementation...
Remote job
HEDIS
Quality
Elevance Health
Manchester, NH
22 hours ago
Medical Review Nurse
$7.25 per hour
...costs. The Medical Review Nurse - CMS / RAC (... .... You will work remotely in a fast paced and... ...Knowledge of insurance programs program,... ...Ability to maintain high quality work while meeting... ...Active unrestricted RN license in good standing... ...of Work On-site Requisition ID...
Remote work
Quality
Website
Hourly pay
Full time
For contractors
Work at office
Shift work
Machinify, Inc.
La Grange, KY
1 day ago
Clinical Medical Review Nurse
...Clinical Medical Review NurseWe are seeking Licensed Practical... ...(LPN) or Registered Nurses (RN) to join the Quality team as Clinical Medical Review... ...position requiring both remote work and regular onsite presence... ...qualifications:HEDIS experience (preferred but not...
Remote work
HEDIS
Quality
Contract work
Work at office
2 days per week
3 days per week
Lumen Solutions Group Inc.
Baltimore, MD
1 day ago
Communicable Disease Program RN
...works in a variety of either remote or clinic locations to serve a... ...effectively and efficiently to provide quality appropriate care in accordance... ...protocols. These variety of sites include but are not limited to... ...~ Awards and recognition programs Amergis, formerly known...
Remote work
Quality
Website
Weekly pay
Contract work
Local area
Amergis Healthcare Staffing
White Plains, MD
2 days ago
Senior Quality Improvement Specialist (RN)
...Senior Quality Improvement Specialist (RN) Location: NYCLAY (100% remote) Duration: 45 W, 3 D Client: Molina... ...Improvement Compliance, HEDIS, and / or Quality Reporting... ...to provide project-, program-, and / or initiative-... ...; preparation and review of potential quality of...
Remote work
HEDIS
Quality
Saviance
United States
22 hours ago
HEDIS RN / LPN
...HEDIS RN / LPN Integrated Resources, Inc is a premier... ...only the best quality talent, the first time... ...Experience in medical record review preferred Some travel involved... ...complete the training program offered, and meet &... ...include performing either on-site medical record review...
HEDIS
Quality
Website
Contract work
Work at office
Careers Integrated Resources Inc
Brentwood, TN
1 day ago
Manager of Case Management (RN Required)
...impact Care Management program in a value-based... ...hiring a hands‑on RN leader to build and... ...measurable improvements in quality, utilization, and... ...using data (HEDIS, Arcadia, or similar... ...utilization management reviews Analyze utilization... ...& Requirements Remote/Hybrid work environment...
Remote work
HEDIS
Quality
Contract work
Flexible hours
Afternoon shift
Anacalifornia
Brooklyn, NY
3 days ago
Customer Success Manager
...value - Deliver quarterly business reviews with clear ROI narratives tied to utilization... ...experience Familiarity with CMS quality programs (HEDIS, Stars, MIPS) What We Offer... ...work environment with flexibility (remote + on-site in the San Francisco Bay Area)...
Remote work
HEDIS
Quality
Website
Rainfall Health
San Francisco, CA
22 hours ago
Registered Nurse - Sepsis Program Coordinator - RN
$96.18k - $144.33k
...City Phoenix State AZ Remote NO Department Nursing Why Mayo... ...The primary focus of the RN Program Coordinator is to coordinate a high quality, safe, effective, and efficient program... ...International Assignment No Site Description Just as our...
Remote work
Quality
Website
Full time
Monday to Friday
Flexible hours
Mayo Clinic
Phoenix, AZ
25 days ago
Clinical Quality Reviewer
...dedicated to improving the quality of care for patients in... ...The Clinical Quality Reviewer supports TapestryHealth... ...with CMS, NCQA, HEDIS, and HIPAA/OIG standards... ...documentation, coding, care program compliance (CCM/RPM),... ...Preferred: ~ RN clinical license...
Remote work
HEDIS
Quality
Tapestry
United States
2 days ago
Data Engineer II
$104.04k - $137.84k
...data reliability and quality. This role is... ...incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA... ...fitness center on-site.Medical Insurance with... ...peer and lead code reviews per code review... ...(Monday & Friday - remote, Tuesday - Thursday...
Remote work
HEDIS
Quality
Website
Temporary work
Work experience placement
Monday to Friday
Flexible hours
Inland Empire Health Plan
Rancho Cucamonga, CA
1 day ago
Director, Population Health Pharmacy; Full Time; Days
$140k - $230k
...strong reputation for quality of care and... ...and care transition programs across a large and... ...quality performance, remote patient monitoring,... ...antifungalsOversee of site-of-care optimization... ...of polypharmacy review and medication reconciliation... ...management, HEDIS/Star Ratings...
Remote work
HEDIS
Quality
Website
Full time
Contract work
Traineeship
Local area
Shift work
Mount Sinai Health System
New York, NY
1 day ago
Director Product Management - Care Coordination
....g., value-based care programs, CMS interoperability rules, quality measurement under HEDIS and Stars, chronic care... ...transitions of care, remote monitoring, and patient... ...customer interviews, site visits, advisory councils... ...site. Thank you for reviewing this Veradigm...
Remote work
HEDIS
Quality
Website
Temporary work
For contractors
Local area
Veradigm LLC
Raleigh, NC
22 hours ago
Program Manager - REMOTE
...Job Summary Provides program management and strategic oversight for provider engagement, quality improvement, and risk adjustment initiatives... ...collateral. Routinely reviews program collateral to ensure... .... Understanding of HEDIS, CAHPS, STAR Ratings, and quality...
Remote work
HEDIS
Quality
SAN ANTONIO STAFFING
United States
22 hours ago
Manager, Case Management SNP (California RN License Required)
$113.33k - $170k
...compliance with SNP program requirements as... ...while ensuring high-quality care management and... ...Location: Fully Remote – California (Outside... ...Utilization Management, HEDIS/STARs, and Quality... ..., performance reviews, and staff development... ...Degree in Nursing (RN) Preferred: BSN...
Remote work
HEDIS
Quality
Full time
Monday to Friday
Alignment Health
Indiana
more than 2 months ago
Registered Nurse (RN) In Home Medical Care - Atlanta GA
$77k - $112.58k
...Registered Nurse (RN) We are seeking... ...) to deliver high-quality, patient-centered... ...patient histories Reviewing medications and... ...preventive care and HEDIS quality gaps, including... ...required training programs, including... ...patients, families, and remote healthcare...
Remote work
HEDIS
Quality
Work at office
Local area
WellBe Senior Medical
Snellville, GA
1 day ago
Facility Site Review Nurse (LVN/LPN)- Remote in CA
$30.37 - $59.21 per hour
...Description Provides support for clinical facility site reviews. Under the supervision of leadership, uses... ..., and identify opportunities for ongoing program improvement. Contributes to overarching strategy to provide quality and cost-effective member care. Conducts...
Remote job
Quality
Website
Hourly pay
Work experience placement
Work at office
Local area
Night shift
3 days per week
Molina Healthcare
San Diego, CA
3 days ago
Healthcare Data Analyst II
$91.25k - $120.91k
...direction of the Quality Systems Leadership... ...Provider departments, programs, and quality... ...but not limited to, HEDIS, CAHPS, and NCQA Accreditation... ...fitness center on-site ~ Medical... ...by an independent reviewer. # Designs and... .... (Mon & Fri - remote, Tues - Thurs onsite...
Remote work
HEDIS
Quality
Website
Temporary work
Work experience placement
Flexible hours
Inland Empire Health Plan
Rancho Cucamonga, CA
22 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote RN - Quality Program & Site Review (HEDIS). Be the first to apply!