LVN HEDIS Data Abstractor & Utilization Review Specialist
HealthCare Support
A prominent healthcare recruiting firm in California is seeking a Licensed Vocational Nurse to manage data abstraction from medical records and coordinate clinical quality initiatives. The ideal candidate will have an active vocational nurse license and solid experience in paper charting. Responsibilities include managing HEDIS projects and improving clinical quality metrics. This position offers a competitive salary and benefits including medical, dental, and vision coverage. #J-18808-Ljbffr
- ...Licensed Vocational Nurse /LVN – Utilization Review (HEDIS Abstractor) HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare... ...rewarding career! • This person will be abstracting data from medical records and entering into the database....HEDISPrivate practiceWork at officeMonday to Friday
$35 - $45 per hour
...Neier Inc. is looking for an experienced RN / Utilization Review Nurse in Sacramento for a potential contract to hire position. This role involves... ...regulations. The ideal candidate will have an active LVN license, a minimum of 3 years of clinical experience, and strong...SuggestedHourly payContract work- ...Canon Recruiting Group is hiring an RN / Utilization Review Nurse for a potential contract to hire position in Sacramento, CA. This role involves... ...timely care decisions. Applicants must have an active LVN license and at least 3 years of clinical experience. Strong communication...SuggestedWeekly payContract workMonday to Friday
- ...Promise Health Plan Senior Medical Director, Utilization Management. The Promise Health Plan... ...and retrospective utilization review, and retrospective provider claims dispute... ...requirements, measurement of health care quality (HEDIS and CAHPS) and California Department of...HEDISWork at office
$33 - $38 per hour
...Serenity Knolls is seeking a Full Time On-Site Utilization Review Specialist at our substance use facility located in the beautiful San Geronimo Valley. The role involves monitoring service utilization and ensuring optimal reimbursement. Candidates should possess a high...SuggestedHourly payFull time$33 - $38 per hour
...Overview Serenity Knolls is seeking a Full Time On‑Site Utilization Review Specialist at our substance use facility. Proactively monitor utilization of services for patients to optimize reimbursement for the facility. Hourly pay rate: $33.00‑$38.00 Serenity Knolls is located...Hourly payFull timeWork at office$120k - $185k
A leading infrastructure company based in California is seeking experienced Utility Coordinators for future opportunities. The ideal candidates will manage utility coordination for complex infrastructure projects, ensuring alignment with stakeholders and regulatory requirements...Flexible hours$27.61 - $53.83 per hour
...DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services... ...teams to promote the Molina care model. Adheres to utilization management (UM) policies and procedures. Required Qualifications...Hourly payContract workWork experience placementWork at office$27.61 - $53.83 per hour
...Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services... ...multidisciplinary teams to promote the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required...Hourly payContract workWork experience placementWork at office$27.61 - $53.83 per hour
...DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services... ...teams to promote the Molina care model. Adheres to utilization management (UM) policies and procedures. Required Qualifications...Hourly payContract workWork experience placementWork at office- ...and constant keying of information into data system. Employee carries one carton of documents... ...and job requirements: The Data Entry Specialist pulls individual medical files from the... ...is entered. When all files have been reviewed, they are returned to the box, which is...
$75.2k - $112.8k
...provider engagement and leveraging data to improve value delivered to... ...care and achievement of HEDIS performance; implement... ...Analyze provider reports on cost, utilization, and outcomes, and present data... ...quarterly physician record reviews or as needed with network providers...HEDISLocal areaRemote work$2,400 - $10,000 per month
...CMS Regulations and NCQA HEDIS Guidelines Knowledge of... ...accurate and thorough review of the assigned member... ...respect to any aspect of the data handled or services... ...or Clinical Nurse Specialist in Family, Adult, Gerontology... ...tools This company utilizes E‑Verify. ComplexCare Solutions...HEDISDaily paidLocal areaRemote work- ...reporting solutions to assist HEDIS audit, rate tracking, and Identifying... ...reports. Assist Quality Data Analytics Leaders in... ...reporting. Develop Medical Record Review project reporting to track... ...determine significance and relevance. Utilize extrapolation, interpolation,...HEDISWork at officeRemote work
- ...26 Most recent review date: Saturday, May 30, 2026... ...EXPERTISE The Junior Specialist has the general duties of... ...Assist with database creation, data collection and processing *... ...Demonstrated problem solving skills, utilizing available resources and good...Full timeWork at officeLocal areaAfternoon shift
$55.93k - $107.62k
...details about this job. Realty Specialist (CASIE) (1) Sacramento, CA... ...more senior Realty Specialists. Review, analyze and make... ...grants, disposal and changing utilization of property. Prepare standard... ...Prepare reports by inputting data into appropriate authoritative...- ...Item Processing Specialist The Item Processing Specialist is a seasoned... ...processing efficiently. Utilize various item processing... ...transactions. Conduct thorough reviews of processed transactions to... ...process of items. Perform data entry tasks with a high level...Work at officeImmediate start
$76k - $199.6k
...uses judgment to maintain customer engagement by successfully utilizing existing and ever-changing digital tools effectively for successful... ..., generally for public disclosure. Subject to further legal review and statutory or regulatory clarification, which Pfizer intends...Permanent employmentFull timeH1bLocal areaRemote workVisa sponsorshipWork visaRelocation package$144.5k - $175.1k
...working expertise on emerging data for approved indications.... ...interacting with HCPs. Utilizing various digital communication... ...Requisition number so we can review. Communications related to your... ...EG-90 - Senior Therapeutic Area Specialist, Oncology (Sacramento, CA)Hourly payFull timeTemporary workPart timeFor contractorsSummer workPrivate practiceLive inWork at officeLocal areaRemote workFlexible hoursShift work- ...compliance with all federal regulations Utilize intake methods such as email, Ebond (... ...processing from intake to billing, including review of order provisioning and billing setup... ...intake and management and/or experience with data entry. Experience within federal...Contract workWork at office
$28.9 - $35.92 per hour
...analysis and correction, authorization/referral review and claim attachments. Review and... ...levels in and outside of the health system; utilizes effective listening and questioning... ...information contains accurate and comprehensive data to provide timely billing and optimal...Hourly payFull timeContract workTemporary workPart timeLocal areaImmediate startMonday to FridayFlexible hoursShift work$15 per hour
...Datavant is the data collaboration platform trusted for healthcare. Guided by our mission... ...Basic computer proficiency. Comfortable utilizing phones, fax machine, printers, and other... ...exempted from these requirements will be reviewed by Datavant Human Resources and determined...Hourly payFull timeWork experience placementWork at office$27 per hour
...OVERVIEW The Outreach and Engagement Specialist (OES) reports to Cal Voices' CalAIM Quality... ...eligibility verifications; monitors and reviews clients' eligibility, insurance, and... ...solving Regularly maintain resilience and utilize effective coping techniques in response...Work experience placementWork at officeLocal areaImmediate startMonday to FridayShift workNight shift3 days per week$19.46 - $29.19 per hour
...Enrollment Specialist Job Category: Administration Requisition Number... ...and eligibility. Utilizes waiting lists in accordance with... ...governing regulations. Data Compliance Support Completes... ...further information, please review the Know Your Rights notice...Hourly payFull timeMonday to FridayFlexible hoursShift work- ...Platform to leverage employed specialists to deliver in-home specialty... ...providers the MPE is expected to review and approve care plans and... ..., inpatient/outpatient utilization, pharmacological prescribing... ...multi-specialty platform and HEDIS/Gap Closure. Actively lead daily...HEDISLocal areaRemote workFlexible hours
$55.93k - $107.62k
...Wayne State University is hiring a Realty Specialist in Sacramento, CA, offering a starting salary of $55,934 - $107,620 per... ...real property management, developing acquisition plans, and reviewing property utilization requests. Candidates must be U.S. citizens and have a...$15 - $18.32 per hour
...Datavant is the data collaboration platform trusted for healthcare. Guided by our mission... ...computer proficiency. Comfortable utilizing phones, fax machine, printers, and other... ...exempted from these requirements will be reviewed by Datavant Human Resources and determined...Hourly payFull timeWork experience placementWork at office$102k - $132k
...safety, productivity, and performance. Leads the development, review, and maintenance of guidance documentation. Identifies... ...or GED-General Educational Development-GED Diploma ~8 years utility industry experience (electric or telecommunications) Desired...Remote workFlexible hours$24.77 - $27.86 per hour
...treatment team, the Independent Living Specialist (ILS) is responsible for providing vocational... ...plans for each child.Attends and utilizes all training that is provided, in compliance... ...in staff meetings, training, case reviews and other meetings as required.Communicates...Hourly payTemporary workWork at officeMonday to FridayWeekend work- ...Housing and Community Development Specialist II (HCDS II) will be... ...for collection and analysis of data for performance and operational... ...data analysis assignments by utilizing research methods and knowledge... ...management including review of project financial statements...Permanent employmentFull timeTemporary workWork experience placementWork at officeLocal areaRemote workFlexible hours
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