HEDIS Review Specialist

Insight Global is looking for a talented HEDIS nurse reviewer to join their team. As a HEDIS Overreader Registered Nurse, you will be responsible for reviewing healthcare data and software to ensure quality and accuracy.Job SummaryReview healthcare data and software to ensure quality standards are metEvaluate health plans against healthcare facility...

Benefits and RequirementsWe are offering a unique opportunity for a HEDIS Registered Nurse or LPN to join our team as a Clinical Quality Specialist. This is a partially remote contract position based in Pennsylvania and New Jersey, requiring occasional travel to onsite reviews. In exchange for your hard work and dedication, you will receive a competitive...

Performance Development Group is a global leader in providing collaborative advisory services and innovative performance improvement solutions. We are currently seeking an experienced Editorial/QC Specialist to join our team.The ideal candidate will have 8-12 years of experience working as an editor or QC Specialist, with a proven track record of delivering...

We are seeking a skilled HEDIS nurse reviewer to join our team at Insight Global. As a HEDIS Overreader Registered Nurse, you will be responsible for reviewing healthcare data and software to ensure quality standards are met.Key ResponsibilitiesConduct thorough reviews of medical records to ensure patient care meets health plan needsUse HEDIS measuring...

Job OverviewTemple University Hospital seeks a skilled Nurse Utilization Review Specialist to join our team. This role is responsible for ensuring the efficient handling of complex authorization issues in the Pre-certification Department.Key ResponsibilitiesServing as the primary clinical resource for precertification/authorization issues, ensuring timely...

Role OverviewWe are seeking a skilled Editorial/QC Specialist to join our team at Performance Development Group. This role is ideal for individuals with experience in editing and reviewing content, ensuring high-quality deliverables that meet client expectations.About the JobThe successful candidate will work closely with our team to review and edit various...

Job Title:Quality Management Performance Evaluation Specialist - Behavioral Health ExpertAbout the Position:Community Behavioral Health (CBH) is seeking a highly skilled Quality Management Performance Evaluation Specialist to join our team. In this role, you will be responsible for planning, designing, implementing, conducting, and reporting performance...

Unlock Your Potential as an ESOP ReviewerWe are seeking a skilled and detail-oriented individual to join our team as an ESOP Reviewer at Transition Finance Strategies LLC. Located in Charlottesville, VA, Columbia, MD, Columbus, OH, Westchester, IL, Pasadena, CA, and Maple Grove, MN, our offices offer a collaborative environment where you can grow your career...

Job Summary:We are seeking a skilled and compassionate Registered Nurse to join our team as a Healthcare Advocate - Chronic Care Specialist. In this role, you will be responsible for providing exceptional patient care and support to individuals with chronic conditions.Key Responsibilities:Conduct in-home visits and assessments to identify patients'...

Care Coordination SpecialistAt Cigna Healthcare, we advocate for better health through every stage of life. As a Care Coordination Specialist, you will be the key contact point for patients to coordinate and streamline all services offered within Evernorth Health Services. You will serve as the liaison between providers and their patient panel, directing and...

Purchasing SpecialistLPW Group is seeking a skilled Purchasing Specialist to join our team. As a Purchasing Specialist, you will be responsible for sourcing and purchasing all non-capital needs of the company. This includes computer equipment, office supplies, factory and operating materials, raw materials, products for resale, and services.In this role, you...

Job DescriptionPDG is looking for a talented Editorial/QC Specialist to support our ongoing needs. The selected candidate will work on a project basis, reviewing and editing content to ensure high-quality deliverables.About the RoleThe Editorial/QC Specialist will be responsible for:Reviewing and editing content for spelling, grammar, and clarityEnsuring...

Job OverviewAt LPW Group, we are seeking a highly skilled Purchasing Specialist to join our team in Houston, TX. This is a fantastic opportunity to work with a leading manufacturer of specialty valves, fittings, and other flow control products. As a Purchasing Specialist, you will be responsible for sourcing and purchasing all non-capital needs, including...

Role SummaryAs a Surveillance Operations Specialist at Ethos Risk Services, you will utilize your skills to capture video evidence, review files, and draft detailed case reports. This role requires adaptability, attention to detail, and strong analytical capabilities.

Job Title: Care Coordination SpecialistAbout the Role:Care Coordination Specialists at Community Behavioral Health are responsible for coordinating care activities and collaborating with stakeholders involved in a member's case. This includes utilization management, population management, cross-system consultation, and treatment quality monitoring.Key...

Key ResponsibilitiesThe Customer Growth Specialist will be responsible for expanding and retaining our customer base, building trusting relationships with key stakeholders, and meeting revenue growth goals. Key responsibilities include:Conducting quarterly business reviews and annual account reviews with customers.Developing a robust people map and...

Job Title: Education SpecialistAbout the Role:This position is responsible for conducting psychoeducational evaluations of students suspected of needing special education. The successful candidate will administer standardized cognitive and achievement tests, as well as social/emotional/behavioral ratings scales from parents and teachers. They will also write...

Job Title: Early Intervention SpecialistWe are seeking a skilled and compassionate Early Intervention Specialist to join our team at SPIN, Inc. in Northeast Philadelphia.About the Role:This is a per direct hour position, including direct therapy, face-to-face evaluations, and attendance at IFSP team reviews.The ideal candidate will have experience working...

YesCare CorpAs a night shift Physician Specialist, you will be responsible for providing community-standard care based on evidence-based medicine for clinical services required, including but not limited to sick call, chronic care, History and Physicals, and all emergency care needs. The goal is to provide the right care, at the right time, and at the right...

Key ResponsibilitiesThe Customer Relationship Specialist will be responsible for cultivating and maintaining strong client relationships to enhance retention and drive growth. They will conduct thorough policy reviews, offer tailored recommendations, and resolve complex customer issues with confidence and expertise.This is a fantastic opportunity for someone...