HEDIS Chart Review Specialist (RN/LVN)
Shell Lubricants Hub Hamburg
Shell Lubricants Hub Hamburg is seeking a Healthcare Consultant II in Florida. This position requires strong experience in performing chart audits and reviewing medical records, particularly with HEDIS standards. Candidates should possess a professional demeanor and a solid work ethic. Essential qualifications include medical terminology knowledge, along with the ability to communicate effectively and utilize Microsoft Office tools. Educational qualifications may include an RN/LVN with an associate or bachelor degree, although HEDIS review experience may substitute for licensing. #J-18808-Ljbffr
- ...Health Business Solutions LLC seeks an experienced Utilization Review Nurse in New York to provide clinical guidance, drive appropriate... ...utilization criteria, and collaborate with insurers on denials. Requires RN license (US multi-state/compact), BSN preferred, 2+ years UR...Suggested
$73.86k - $98.23k
...of Florida, New York. The successful candidate will perform chart reviews, facilitate healthcare communication, and ensure optimal patient... ...include an Associates degree, MCG Care Guidelines Specialist certification, and a minimum of three years nursing experience...Suggested- ...TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews,...SuggestedRemote work
$55k - $70k
...Utilization Review Specialist – Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K Who We Are Exact... ...licensure or certification (e.g., BCBA, LSW, LMHC, PT, OT, SLP, RN). Proven experience in utilization review or a related field...SuggestedWork at officeRemote workFlexible hours- A growing healthcare company in New York seeks a Utilization Review Nurse to conduct clinical reviews and ensure medical necessity authorizations are met. The ideal candidate will be an LPN or RN with critical thinking skills and attention to detail, able to manage tasks...Suggested
- ...Weekend Baylor Program RN's/LPN's ($10,000 sign on bonus) Join the The Manor At Blue Water... ...of residents Assess patients’ conditions, chart observations, and perform evaluation tasks including vital signs and medication review Administer medication as prescribed by the...Full timeRemote workRelocation packageFlexible hoursShift workWeekend workAfternoon shift
$38 - $44 per hour
...Employer. What We Offer Competitive Pay : RN - $38.00 – $44.00 an hour (based on years... ...forms, reports, evaluations, studies, charting, etc., as necessary. Transcribe physician... ...Monitor AccuChecks Pulse Oximetry as ordered. Review care plans daily to ensure that...Weekly payTemporary workWork at officeRelocation packageShift work$25k
...The Clinical Care Nurse (RN) is a clinic-based nursing role focused on improving patient outcomes. You will support safe Transitions... ...emergency department patients. Quality: Medicare Advantage Stars, HEDIS and quality performance across value-based population. Population...HEDISTemporary workApprenticeshipWork at officeMonday to Friday$25k
...caring community The Clinical Care Nurse (RN) is a clinic-based nursing role focused... ...patients. Quality: Medicare Advantage Stars, HEDIS and quality performance across value-... ...include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more...HEDISFull timeTemporary workApprenticeshipWork at officeMonday to Friday- ...Hollywood, Florida Summary The Data Quality Specialist is responsible for abstracting, analyzing... ..., concurrent, and retrospective clinical reviews and abstractions as assigned. Works with... ...(Required) Registered Nurse License (RN LICENSE) - State of Florida (FL) Additional...Work experience placementWork at officeRemote workShift work
- ...Responsibilities: Prior experience in performing chart audits is preferred. Candidate must commit... ...a folder. Skills: 5 or more seasons of HEDIS experience in reviewing medical records is required Education/Experience: RN/LVN with an associate or bachelor degree is...HEDIS
- ...preferred Experience / Qualifications RN‑ Current RN licensure in the state of Florida... ...Position Summary The Breast Health Specialist nurse is responsible for the physical, emotional... ...when circumstances change. I have reviewed these job requirements and verify that I...ReliefLocal area
$31.53 - $52.24 per hour
...Nursing [Preferred] Licenses and Certifications Registered Nurse (RN) [Required] Basic Life Support - CPR Cert (BLS) [Required]... ...including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements...Full timeWork at officeLocal areaShift workWeekend work- Memorial Healthcare System in Miramar, Florida seeks a seasoned Utilization Management RN to perform initial and continued stay reviews to determine medical necessity and appropriate level of care. You will collaborate with Case Management, support discharge planning,...
- ...online to join #teamMHSflorida.Learn more below.Summary:The Utilization Management RN uses evidence-based medical necessity screening tools to complete initial and continued stay reviews in determining appropriate level of patient care, appropriateness of tests/procedures...Daily paidWork experience placementShift work
- ...Centers is seeking a qualified and compassionate Staff Nurse (LPN/RN) to provide direct nursing care within our inpatient behavioral... ...pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. #J-188...Full timeTemporary work
$55k - $70k
...Utilization Review Specialist – Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K About the Role As a Utilization Review Specialist, you will play a pivotal role in ensuring the efficient and effective utilization of healthcare...Remote workFlexible hours$65k - $70k
Healthcare Performance Improvement Specialist Palm Springs, FL, US 18 days ago Requisition ID: 1249 Salary Range: $65,000.00 To $70,000... ...improve performance across healthcare quality measures (e.g., CMS, HEDIS) and cost/utilization metrics Identify care gaps and variation...HEDIS- ...psychosocial, and environmental needs of home health patients Assess patients’ conditions and chart observations, and perform evaluation tasks including vital signs and medication review Administer medication as prescribed by the patient’s physician Educate patients and...Full timePart timeRemote workMonday to FridayShift workWeekend work
$54.92k - $107.1k
Job Summary Sr Specialist, Provider Engagement role implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures the core set of Tier 2 providers in the Health Plan...HEDISRemote jobWork experience placementWork at office$71.1k - $97.8k
Quality Improvement RN - New Smyrna/Daytona 3 days ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive... ...areas: Quality/clinical management and population health HEDIS and Stars performance Operational improvements Financial...HEDISTemporary workApprenticeshipWork experience placementInternshipWork at officeLocal areaMonday to FridayFlexible hours- ...risks, informed consent, confidential self-exclusion, and reviewing Serological Protein Electrophoresis (SPE) testing as necessary... ...Licensed Practical Nurse (LPN), Licensed Vocation Nurse (LVN), Registered Nurse (RN), Nurse Practitioner (NP), Physician Assistant (PA)...Work experience placementAll shifts
- ...key quality metrics such as HEDIS, Star Ratings, and care gap closure... ...efforts including chart audits, coding accuracy, and... ...managers, and risk adjustment specialists to optimize patient care and... ...clinical meetings, performance reviews, and compliance training as required...HEDISWork at officeLocal area
- Clinic & Injection Room Nurse (LPN/RN) Location: 3854 Sheridan St., Suite B, Hollywood, FL 33021 FLSA Status: Non-Exempt, Hourly Travel... ...be reordered Check refrigerator temperatures daily and log on chart Complete all tasks in Triage when scheduled Prepare patient...Hourly payLocal areaMonday to FridayShift workDay shift
- ...geographically dispersed teams Drive hospitalization reduction, HEDIS/STARs performance, and HCC documentation quality Build and... ...product, technology, and payor contract decisions Own QAPI and chart review processes for the Florida market Partner with the Market...HEDISContract workWork from home
- Location: Cape Canaveral Hospital Position Summary The CV Invasive Specialist RN delivers direct and indirect patient care in compliance with regulatory and departmental processes during Cardiovascular or Interventional Radiology or Interventional Neurology procedures...Full timeWork experience placementShift work
- Health First’s Cape Canaveral Hospital seeks a CV Invasive Specialist RN to deliver direct and indirect patient care during cardiovascular and interventional procedures. You’ll ensure patient safety, assist with imaging, monitor hemodynamics, and communicate with the team...Full timeFlexible hours
- ...collaborating with other professionals for coordinated care, and education for patients and families. Candidates must have a valid Florida RN license and BLS/PALS certifications. This role requires critical thinking and effective communication skills while working in a...
- ...Nurse. The role involves providing nursing care to patients and ensuring compliance with hospital policies. A nursing degree and state RN License are required, along with CPR and ACLS certification. The position offers flexible working days, a supportive team environment...Flexible hours
- ...include collaborating with healthcare teams, evaluating patient needs, and implementing care plans. The ideal candidate must be a licensed RN with at least one year of experience, and have certifications in BLS and ACLS as required. This position offers shifts at night and...Shift workNight shift
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