HEDIS Review Nurse

HEDIS Review Nurse Job DescriptionThis is a contract assignment that will start immediately and end on April 30th, 2024.Job Summary:The HEDIS Review Nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set (HEDIS) survey.Key Responsibilities:Abstract medical recordsApply...

This is a contract position starting on January 6th, 2025 and going until April 30th, 2025 The position is fully remote. The pay is $40/hour for RN's. The pay is $37/hour for LPN/LVN. Review Nurse SUMMARY DESCRIPTION: The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information...

This is a contract position starting on January 6th, 2025 and going until April 30th, 2025The position is fully remote. The pay is $40/hour for RN's. The pay is $37/hour for LPN/LVN.Review NurseSUMMARY DESCRIPTION:The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set...

We are seeking a dedicated and meticulous HEDIS Nurse to assist with the collection, analysis, and presentation of healthcare data. The HEDIS Nurse will be responsible for managing all aspects of the HEDIS (Healthcare Effectiveness Data and Information Set) process, including data collection, verification, and report generation. Our ideal candidate will have...

Job DescriptionAt Superbeo, we are seeking a highly skilled Quality Improvement and Compliance Specialist to join our team. As a key member of our HEDIS team, you will play a critical role in supporting our quality improvement initiatives and ensuring compliance with regulatory requirements.Key ResponsibilitiesConduct medical records chart chasing and data...

Job Title: Clinical Review NurseJob Summary:Elite PC Services is seeking a skilled Clinical Review Nurse to join our team. As a Clinical Review Nurse, you will play a critical role in reviewing Workers Compensation requests to determine medical necessity. Your expertise will be utilized to analyze medical data, apply evidence-based guidelines, and make...

Clinical Quality LPN Job DescriptionAdecco Healthcare & Life Sciences is seeking a Clinical Quality LPN to work from home. This role is a four-month contract with the opportunity for extension or full-time offer.Key Responsibilities:Assist in reviewing medical records to highlight opportunities for the medical staff.Review medical records for data...

Job Title: Utilization Review RNChildren's Health is seeking a skilled Utilization Review Registered Nurse to join our team. As a Utilization Review RN, you will play a critical role in ensuring that our patients receive the highest quality care while minimizing unnecessary costs.Key Responsibilities:Conduct thorough reviews of patient records to determine...

Job Title: Utilization Review NurseWe are seeking a skilled Utilization Review Nurse to join our team at Children's Health. As a Utilization Review Nurse, you will play a critical role in ensuring that our patients receive the most appropriate and effective care possible.Responsibilities:Conduct thorough reviews of patient records to determine medical...

Job SummaryAs a Clinical Utilization Review Nurse at the University of Texas Southwestern Medical Center, you will play a critical role in ensuring the highest quality of care for our patients. Your primary responsibility will be to conduct medical certification reviews for medical necessity for acute care facilities and services. You will use nationally...

Clinical Quality LPN Job DescriptionAdecco Healthcare & Life Sciences is seeking a Clinical Quality LPN to join their team. This is a remote opportunity that offers flexibility and work-life balance.Job Summary:The Clinical Quality LPN will be responsible for reviewing medical records to identify opportunities for improvement. They will also be responsible...

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you...

Job Title: Prior Authorization Nurse Job Description The Prior Authorization Nurse is responsible for analyzing all prior authorization requests to determine the medical necessity of services and appropriate levels of care in accordance with national standards, contractual requirements, and member benefit coverage. The role involves providing...

Job Title: Prior Authorization NurseJob Description The Prior Authorization Nurse is responsible for analyzing all prior authorization requests to determine the medical necessity of services and appropriate levels of care in accordance with national standards, contractual requirements, and member benefit coverage. The role involves providing recommendations...

Prior Authorization Nurse Job SummaryParkland Health and Hospital System (PHHS) is seeking a skilled Prior Authorization Nurse to join our team. As a Prior Authorization Nurse, you will play a critical role in ensuring the quality and cost-effectiveness of patient care by reviewing authorization requests and applying clinical acumen.Key Responsibilities*...

Utilization Review Nurse for Workers' Comp Job Purpose: Review Workers Compensation requests submitted by the provider, requestor, claimant or carrier to determine the medical necessity of the treatment utilizing clinical expertise and evidence-based treatment guidelines. Duties: Perform an evaluation of the medical data for utilization review...

Utilization Review Nurse for Workers' Comp Job Purpose: Review Workers Compensation requests submitted by the provider, requestor, claimant or carrier to determine the medical necessity of the treatment utilizing clinical expertise and evidence-based treatment guidelines. Duties: Perform an evaluation of the medical data for utilization review...

Parkland Health and Hospital System is seeking a skilled Coding Specialist III to join our team. As a Coding Specialist III, you will play a critical role in ensuring the accuracy and integrity of patient medical records.The ideal candidate will have a strong background in coding and abstracting, with experience in ICD-10 CM, PCS, CPT, HCPCS, HCC, HEDIS CAT...

Job Title: Prior Authorization NurseJob Description The Prior Authorization Nurse is responsible for analyzing all prior authorization requests to determine the medical necessity of services and appropriate levels of care in accordance with national standards, contractual requirements, and member benefit coverage. The role involves providing recommendations...

Job SummaryAs a Clinical Utilization Review Specialist at the University of Texas Southwestern Medical Center, you will play a crucial role in ensuring the highest quality of care for our patients. Your primary responsibility will be to conduct medical certification reviews for medical necessity for acute care facilities and services.You will use nationally...