Remote RN Lead: Medicare Advantage Quality & HEDIS
Montage Health
Montage Health is looking for a full-time Registered Nurse Medicare Program Lead to manage Medicare Advantage Quality and Risk Adjustment initiatives. This remote role requires coordination of HEDIS reporting and vendor relationships while ensuring compliance with regulatory standards. The ideal candidate will possess an active RN license and at least 2 years of experience in Medicare Advantage Quality or risk adjustment operations, complemented by clinical practice in healthcare settings. Excellent organizational and compliance skills are crucial for success. #J-18808-Ljbffr
- ...Professional to develop and oversee regional Medicare/Medicaid Stars quality improvement programs. You will analyze... ...experience with Medicare/Managed care, NCQA HEDIS measures, CMS Star rating systems, and interoperability. Remote work with occasional travel to Humana...Remote workHEDISQuality
$25k
...Clinical Care Nurse (RN) is a clinic-based... ...utilization, and drive Medicare Advantage Stars and quality performance. The... ...University City, Patton Ave (Remote), River Hills (... ...Advantage Stars, HEDIS and quality performance... ...stability, industry-leading benefits, and...Remote workHEDISQualityFull timeTemporary workApprenticeshipWork at officeMonday to FridayFlexible hours- ...sheet. Case Manager RN The UHealth System... ...pathways to improve quality of care. Core Job... ...guidelines. Provides remote based care for... ...outcomes reporting, Medicare Advantage HEDIS clinical audits, and... ...health system, provides leading-edge patient care powered...Remote workHEDISQualityFull timeTemporary workWork at officeWorldwide
$25k
...The Clinical Care Nurse (RN) is a clinic-based nursing... ...ED utilization, and drive Medicare Advantage Stars and quality performance. The Clinical Care... ...University City, Patton Ave (Remote), River Hills (Remote).... ...Medicare Advantage Stars, HEDIS and quality performance across...Remote workHEDISQualityTemporary workWork at office- ...adults with traditional Medicare and Medicare Advantage plans, focused on delivering improved quality, better patient... ...work independently in a remote setting. Education... ...Degree in Nursing (BSN) or RN with bachelor's degree... ...knowledge of HEDIS and CMS guidelines preferred...Remote workHEDISQualityWork experience placementWork at office
- ...Inland-Empire-Health-Plan- is seeking a Quality Improvement RN in Rancho Cucamonga, CA. This role involves facilitating quality initiatives to... ...healthcare experience. The position offers a hybrid schedule with remote work on certain days. Key perks include competitive salary,...Remote workHEDISQuality
- ...integrity. We focus on delivering top-quality talent in four specialty areas... ...This position is for the 2018 HEDIS audit. The role involves... ..., along with an active RN or LPN license. The selected nurses... ...meetings are mandatory, with remote work on other days. Additional...Remote workHEDISQualityWork at officeWork from home
- ...Hedis Auditor Rn/Lpn Integrated Resources, Inc is a premier staffing firm recognized as one... ...mission centers on delivering only the best quality talent, the first time and every time.... ...There is weekly onsite meeting which candidate must attend and remote other days....Remote workHEDISQualityContract workWork from home
- ...staffing firm is seeking a skilled RN or LPN to join a dynamic team... ...contract assignment focused on HEDIS reviews. This role involves... ...healthcare projects while working remotely in Texas. Join a team dedicated to improving healthcare quality and making a meaningful impact...Remote workHEDISQualityContract work
- ...Responsible for the HEDIS Medical Record Review process, the... ...specifications while working remotely. Key responsibilities: Review... ...audit preparation and quality reviews Required qualifications... ...required Familiarity with Medicare Advantage lines of business and Stars...Remote workHEDISQualityFull time
$600 - $720 per day
...Practitioner Location/Type: Missouri • Remote (No travel) Pay: $600-$720/day (1099... ...growing healthcare organization supporting Medicare and Medicaid populations through... ...adjustment during patient visits Close HEDIS (quality measures) care gaps Review medical history...Remote workHEDISQualityDaily paidFor contractorsWork from homeFlexible hours- ...Summary of Job Lead and develop meaningful insights, actionable analytics and... ...continuously improve the plan's healthcare quality metric performance (HEDIS/QARR/Star/Accreditation) to drive... ...modeling analyses of quality metrics for Medicare, State Sponsored Programs, and other...Remote workHEDISQualityWork experience placementWork at office
$81.1k - $137.9k
...continuum. Utilize telehealth, remote monitoring, and virtual... ...utilization. Support Medicare‑related care management... ...). Participate in quality improvement initiatives... ...metrics (e.g., HEDIS measures). Collaborate... ...years of experience as an RN in an ambulatory, outpatient...Remote workHEDISQualityTemporary workLocal area- ...Senior Quality Improvement Specialist (RN) Location: NYCLAY (100% remote) Duration: 45 W, 3 D Client: Molina Healthcare 100%... ...Quality Improvement Compliance, HEDIS, and / or Quality Reporting.... ...QI Compliance Acts as a lead specialist to provide project-,...Remote workHEDISQuality
$175k - $200k
...Manager (PMHNP-BC) Remote (U.S.) | Full-Time... ...needs while leading a multidisciplinary... ...standards, support quality initiatives,... ...improve outcomes for Medicare-age adults. What... ...Familiarity with Medicare Advantage, value-based care,... ...HCC concepts, and HEDIS measures Schedule...Remote workHEDISQualityFull time- ...Special Needs Plan (IE-SNP) Medicare Advantage products. The CMO is responsible... ..., clinical operations, quality, population health, and pharmacy... ...compliant decision making. Lead clinical operations, including... ...(including Stars and HEDIS), care management models, and...Remote workHEDISQuality
$75 - $85 per hour
...comprehensive, patient-centered care to Medicare Advantage members residing in skilled... ..., and improve quality of life for a frail senior population... ...while collaborating with remote teams • Ability and... ...Familiarity with Medicare Advantage, HEDIS, STAR measures, risk...Remote workHEDISQualityHourly payPart time- ...working effectively to provide high quality, effective care management to... ..., but not limited to, HEDIS, CAHPS, and NCQA Accreditation... ...unencumbered Registered Nurse (RN) license issued by the California... ...work schedule, Mon – Fri - remote, Tues – Thurs onsite in Rancho...Remote workHEDISQualityTemporary workFlexible hours
$62.7k - $100.4k
...and faith-based organizations to improve quality and meet the needs of the individual, natural... ...Three (3) years Medicaid and/or Medicare managed care experience is preferred Three... ...: Strong understanding of Quality, HEDIS, disease management, supportive medication...Remote workHEDISQualityHourly payWork experience placementWork at officeLocal areaFlexible hoursWeekend workAfternoon shift$37.25 - $54.12 per hour
...Title Registered Nurse (RN) Job Description... ...mission by helping patients lead healthier, more... ...care team. Deliver high-quality, patient-centered care while... ...of preventive care and HEDIS quality gaps, including... ...patients, families, and remote healthcare professionals...Remote workHEDISQualityPart timeWork at officeLocal area$21 - $23 per hour
...father’s pioneering work in Medicare Advantage, Greenbrook is deeply personal... ...achievements. Location Remote within FL, VA, TX, NY, MO (must... ...insurance plans, including accurate HEDIS coding. Serve as the billing... ...of CPT II codes for Quality and HEDIS reporting. Solid knowledge...Remote workHEDISQualityHourly payFull timeLive inLocal area- ...range. Salary range will vary for remote positions outside of... ...POSITION SUMMARY The RN, Quality Improvement (QI) will support... ...GCHP quality performance. • Lead the timely investigation, processing... ...limited to, DHCS Medical Audits, HEDIS® compliance audits, and internal...Remote workHEDISQualityOngoing contractWork from homeVisa sponsorshipWork visaFlexible hours
$72.8k - $130k
...Senior Clinical Quality RN At UnitedHealthcare, we're simplifying... ...provider education related to HEDIS and pay for performance (P4P)... ...retrospectively Coordinating remote and onsite provider medical... ...working with Medicaid and/or Medicare populations in a managed care...Remote jobHEDISQualityMinimum wageFull timeWork experience placementLive inLocal area$321.2k - $375.65k
...Community The Physician Lead combines direct patient... ...multiple centers, ensuring high-quality, value-based care. This... ...Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational... ...managing Medicare Advantage panel of patients with understanding...HEDISQualityTemporary workLocal area- ...who complete in home visits. This fully remote role supports readmission avoidance, care... ...regulatory standards Address clinical quality gaps within NP scope Ensure follow up... ...required) ~ Familiarity with HCC coding, HEDIS measures is a plus (not required) ~ Telehealth...Remote workHEDISQuality
- ...requirements—care management, quality improvement, chronic... ...care coordination. Lead clinical discovery... ...compliance requirements (e.g., HEDIS, CMS, value‑based care... ...with online & remote schedules. Preferred Qualifications... ..., CMS Stars, ACO, Medicare Advantage). Flexible with the...Remote workHEDISQualityTemporary workLocal areaFlexible hours
$25k
...The Clinical Care Nurse (RN) is a clinic-based nursing... ...ED utilization, and drive Medicare Advantage Stars and quality performance. The Clinical Care... ...Medicare Advantage Stars, HEDIS and quality performance across... ...company: CenterWell is a leading healthcare services business...HEDISQualityFull timeTemporary workApprenticeshipWork at officeMonday to Friday$89.8k - $176.7k
...Performance Manager-Medicare Consultant is... ...risk adjustment and quality reporting. Work is... ...care for Medicare Advantage Members Establish... ...to increase their HEDIS performance, facilitate... ...and systems Lead regular Stars and... ...meetings) and 40% remote work You’ll be rewarded...Remote workHEDISQualityMinimum wageFull timeWork experience placementWork at officeLocal area- ...nursing care for groups of patients. Acts in lead capacity to other nursing staff.... ...Licenses and Credentials Registered Nurse [RN - State License] required. Advanced Cardiovascular... ...(67-100%) Hearing Constantly (67-100%) Remote Type Onsite Work Location 789...Remote workQualityShift work
$72.8k - $130k
...Location: This role is Remote in Ohio.... ...and expense) and quality outcomes Drive processes... ...directly impact revenue, HEDIS/STAR measures and... ...Client Services leads to foster teamwork... ...experience with Medicare health care... ...models, and Medicare Advantage 2+ years of experience...Remote workHEDISQualityMinimum wageFull timeTemporary workWork experience placementWork at officeLocal areaMonday to Friday
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