Quality & Compliance RN Analyst — HEDIS & Coding
Highmark Health
Highmark Inc. is seeking a qualified healthcare professional to support compliance, process improvement, and accurate ICD10-CM coding across product lines. You will analyze data, improve documentation, and educate providers on CMS and NCQA standards to enhance member care and STARS performance. The role requires nursing credentials (RN/LPN) or a healthcare-related bachelor's degree, plus experience in HEDIS/HCC coding and Medicaid/Medicare environments. Travel and site visits may be involved. #J-18808-Ljbffr Highmark Health
$72.8k - $130k
...Growing together. The Sr. Clinical Quality Consultant RN will drive consistency, efficient... ...Provide analytical interpretation and STARS/HEDIS performance summaries to provider groups... ...review experience ~ Billing and CPT coding experience ~ Medicare and/or managed...HEDISMinimum wageFull timeWork experience placementWork at officeLocal area- ...in accordance with regulatory standards - Address clinical quality gaps within NP scope - Ensure follow up appointments, referrals... ...conditions is a plus. (not required) • Familiarity with HCC coding, HEDIS measures is a plus (not required) • Telehealth experience...HEDISRemote work
$62.7k
...departments in the areas of compliance, process improvement,... ...record review and coding, and member and provider... ...related to the potential of quality medical care and... ...to providers on STARS, HEDIS, and HCC Coding. Conduct... ...Required Current state RN or LPN license or Bachelor...HEDISRemote jobFor contractorsWork at officeLocal area$104.5k - $156k
...in providing patient care under a Value Based Care Model * Experience in outpatient Primary Care * Knowledge of HEDIS measures, CAHPS, HOS, HCC Coding documentation * Proficient in Medicare Annual Wellness visits * Proficient in EMR systems & technology (EPIC...HEDISMinimum wageFull timeWork experience placementLocal areaRelocation packageMonday to Friday$109.5k - $164k
...Preferred Qualifications: * Experience in providing patient care under a Value Based Care Model * Knowledge of HEDIS measures, CAHPS, HOS, HCC Coding documentation * Proficient in Medicare Annual Wellness visits * Proficient in EMR systems & technology (EPIC Preferred...HEDISMinimum wageFull timeWork experience placementLocal areaWork from homeRelocationMonday to Friday- ...through CenterWell Senior Primary Care seeks a Clinical Care Nurse (RN) to support transitions of care, reduce avoidable readmissions,... ...on post-discharge follow-up, education, and performance on Stars/HEDIS measures, with in-center weekday hours and community outreach as...HEDISWeekday work
- UnitedHealth Group seeks a Sr. Clinical Quality Consultant RN to drive STARS and quality improvement across the Inner West Valley Phoenix region. This hybrid role combines remote work with in-person meetings and trainings, supporting providers to achieve higher quality...HEDISRemote work
- ...in providing patient care under a Value Based Care Model Experience in outpatient Primary Care Knowledge of HEDIS measures, CAHPS, HOS, HCC Coding documentation Proficient in Medicare Annual Wellness visits Proficient in EMR systems & technology (EPIC Preferred...HEDISFull timeRelocationMonday to Friday
- ...healthcare organization in Phoenix is hiring a Clinical Quality Coordinator, requiring an RN license from Arizona and at least 3 years of nursing... ...policies, coordinating educational programs, and ensuring compliance with regulatory standards. Candidates should possess...Full time
- ...Experience: HealthCare Data Analyst Responsibilities: Analyze healthcare... ...terms (e.g. PMPM, CPT, ICD coding, HCPCS, DRG etc.)... ...population and maintenance of health quality historical data mart Responsible... ...analysis, SQL programming, or HEDIS reporting Additional experience...HEDIS
$25k
...Clinical Care Nurse (RN) The Clinical Care Nurse (RN) is a... ...Medicare Advantage Stars and quality performance. The Clinical Care... ...Quality: Medicare Advantage Stars, HEDIS and quality performance across... ...outcomes accurately and in compliance with organizational and CMS regulatory...HEDISTemporary workWork at officeMonday to Friday$25k
...community The Clinical Care Nurse (RN) is a clinic-based nursing... ...Medicare Advantage Stars and quality performance. The Clinical Care... ...: Medicare Advantage Stars, HEDIS and quality performance across... ...outcomes accurately and in compliance with organizational and CMS regulatory...HEDISFull timeTemporary workApprenticeshipWork at officeMonday to Friday$25k
...The Clinical Care Nurse (RN) is a clinic-based nursing role... ...Medicare Advantage Stars and quality performance. The Clinical Care... ...Quality: Medicare Advantage Stars, HEDIS and quality performance across... ...and outcomes accurately and in compliance with organizational and CMS...HEDISFull timeTemporary workApprenticeshipWork at officeMonday to Friday- ...inclusivity, human kindness, and high-quality care. Recognized by Inc. 5... ..., including billing, coding, claims management, payment... ...cash flow, ensuring regulatory compliance, and building scalable... ...quality incentive programs, STARS, HEDIS, and other population health...HEDISContract workWork at office
$104.5k - $156k
...Experience in providing patient care under a Value Based Care Model Experience in outpatient Primary Care Knowledge of HEDIS measures, CAHPS, HOS, HCC Coding documentation Proficient in Medicare Annual Wellness visits Proficient in EMR systems & technology (EPIC...HEDISMinimum wageFull timeWork experience placementLocal areaWork from homeRelocation packageMonday to Friday- Bilingual Quality Specialist Suvida Healthcare LLC Phoenix, Arizona, United States About... ...staff to identify gaps in care, capture HEDIS documentation, perform chart audits, track... ...basic understanding of billing and claims coding Experience reviewing Electronic Medical Records...HEDISLocal areaMonday to Friday
- ...Registered Nurse (RN) | Progressive Care Unit Location: Sun City, AZ Agency... ...Staffing Agency by Staffing Industry Analysts (SIA) in 2023 , Access Healthcare has rapidly... ...commitment to the highest standards of quality, compliance, and patient safety. As a certified...Weekly payDaily paidPermanent employmentFull timeContract workSummer workShift work3 days per week
$2,151 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Sun... ...health records (EHR). Ensure compliance with all legal, regulatory,... ...promptly to emergencies, including code blue situations or significant... ...or training initiatives. Quality and Compliance: Follow all...Full timeContract workShift work$2,146 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Phoenix... ...records (EHR). Ensure compliance with all legal, regulatory, and... ...promptly to emergencies, including code blue situations or significant... ...or training initiatives. Quality and Compliance: Follow all...Full timeContract workFlexible hoursShift work- ...The Registered Nurse (RN) will play a pivotal role... ...to delivering high-quality nursing services across... ...Data & Information Set (HEDIS) care gaps of required... ...clinical team to ensure compliance with Joint Commission,... ...Adherence to Compliance and Code of Conduct All...HEDISTemporary workWork at officeRotating shift
- ...Governance, Risk & Compliance (GRC) Analyst (AI Training) About The Role We're looking for experienced GRC professionals to help build and... ...partner with the world's leading AI research labs to create high-quality training data - and your real-world expertise is exactly...Hourly payOngoing contractContract workFreelanceRemote workFlexible hours
- ...Registered Nurse (RN) | Emergency Room (ER) / Trauma Location: Phoenix, AZ... ...Growing Staffing Agency by Staffing Industry Analysts (SIA) in 2023 , Access Healthcare has... ...commitment to the highest standards of quality, compliance, and patient safety. As a certified...Weekly payDaily paidPermanent employmentFull timeContract workSummer workShift work3 days per week
- ...procedural environment. The Circulating RN coordinates nursing care within the operating... ...operating-room environment and promote compliance with infection-prevention and safety... ...opportunities for improvement. Safety, Quality, and Compliance Follow all infection-control...Full timeImmediate startMonday to FridayEarly shift
- ...Governance, Risk & Compliance (GRC) Analyst (AI Training) About The Role We're looking for experienced GRC professionals to help build and... ...partner with the world's leading AI research labs to create high-quality training data - and your real-world expertise is exactly...Hourly payOngoing contractContract workFreelanceRemote workFlexible hours
$2,146 per month
...Nursing Profession RN Specialty PCU... ...health records (EHR). Ensure compliance with all legal, regulatory, and... ...promptly to emergencies, including code blue situations or significant... ...training initiatives. Quality and Compliance: Follow all...Weekly payShift workNight shift$2,364.84 per month
...Nursing Profession RN Specialty NICU Job... ...are not limited to: Performing quality checks and ensuring compliance with safety standards. Collaborating... ...Thomas Rd City Phoenix State AZ Zip Code 85037Weekly payShift workNight shiftAfternoon shift$83.63k - $109.76k
...Oscar. We are hiring a Senior Clinical Quality nurse to join our team.Oscar is the first... ...clinical decision making across teams. Compliance with all applicable laws and regulations... ..., case management or population health, HEDIS measures and other regulatory requirements...HEDISFull timeRemote workWork from homeHome office$40 - $42 per hour
...outcomes and achieve their goals by connecting them with highly skilled and qualified professionals. Overview: We are offering a HEDIS course to individuals looking to start working as a HEDIS Abstractor. Once the course is completed, we will connect you with hiring...HEDISRemote work$300k
...with the time and resources to prioritize quality over volume. Position Highlights:... ...scheduler, behavioral health, social work, RN support ~ Holistically designed centers... ...attainable quality and satisfaction metrics (HEDIS, outcomes, etc.) Ongoing support from...HEDISRelocation package$36.8 - $59.89 per hour
...Certifications: Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation... .... Performs patient bedside lab testing and associated quality control in compliance with medical provider’s orders and hospital lab procedures/...Work experience placementLocal areaShift work
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