HEDIS Review and Compliance Nurse

Job Title: HEDIS Clinical Review NurseWe are looking for a detail-oriented and organized HEDIS Clinical Review Nurse to join our Alura Workforce Solutions team. In this role, you will support the Clinical Quality Improvement (CQI) Supervisor and HEDIS Nurse RN with various tasks related to HEDIS and quality improvement.About the JobThis temporary assignment...

HEDIS Improvement Nurse-RNAt Alura Workforce Solutions, we are seeking a skilled HEDIS Improvement Nurse-RN to support our Clinical Quality Improvement team and other departments on HEDIS improvement related issues.The ideal candidate will be able to interpret clinical data for QI-related studies, maintain working knowledge of MedHOK, business processes, and...

At Inland Empire Health Plan, we are dedicated to delivering high-quality healthcare services to our members. Our team is committed to promoting the well-being of our community, and we are seeking a skilled Medical Reviewer to join our Special Investigations Unit (SIU). **Job Summary:**We are looking for an experienced Medical Reviewer to perform thorough...

Company Overview:Inland Empire Health Plan (IEHP) is a leading healthcare organization dedicated to healing and inspiring the human spirit. As a dynamic and innovative team, we strive to provide exceptional care and services to our members.Salary: $80,059.20 - $106,059.20 per yearJob Description:We are seeking an experienced Senior Special Investigations...

About the RoleBlue Shield of California and Promise Health Plan are seeking a skilled Clinical Quality Analytics and Informatics professional to join our team. As a Clinical Quality Analyst - Senior, you will play a critical role in delivering high-quality clinical analytics and informatics to support our mission of providing excellent member-centered...

Job OverviewWe are seeking a highly skilled Tax Resolution Specialist to join our team at Peter Holtz CPA. As a key member of our tax planning and consulting services, you will play a vital role in assisting clients with tax-related issues and ensuring compliance with tax regulations.Key Responsibilities:Client Consultation: Meet with clients to understand...

Overview:Blue Shield of California seeks a highly skilled Healthcare Data Analyst Lead to join the Clinical Quality Analytics and Informatics team.The ideal candidate will possess expertise in data analysis, reporting, and business intelligence to drive quality strategy, performance improvement, and regulatory compliance.About the Role:This senior-level...

Job OverviewThe Utilization Management Nurse, Senior role at Blue Shield of California is a critical position that requires a seasoned professional with expertise in clinical review and prior authorization. This individual will be responsible for conducting thorough assessments of inpatient admissions and length of stay to ensure compliance with regulations...

Job SummaryIn this challenging and rewarding role as a Senior Utilization Management Nurse at Blue Shield of California, you will be responsible for reviewing inpatient stays to ensure medical necessity in compliance with state and federal regulations. Your expertise in clinical review, discharge planning, and presenting cases to the Medical Director will...

Company OverviewInland Empire Health Plan (IEHP) is a leading health plan dedicated to delivering high-quality, patient-centered care. Our mission is to inspire the human spirit by improving healthcare and wellness in our communities.Salary and BenefitsWe offer a competitive salary range of $43.87 - $58.13 per hour, with opportunities for annual merit...

About the JobWe are looking for an experienced Registered Nurse to join our team as an Integrated Transitional Care Nurse. In this role, you will play a critical part in ensuring seamless transitions between care settings, working closely with healthcare providers to deliver continuous, quality healthcare to high-risk members. Your expertise will help us...

About this RoleThe Grievance and Appeals Nurse serves as a key liaison between the company, IPAs, hospitals, and other stakeholders to ensure that grievances and appeals are processed efficiently and in accordance with regulatory guidelines. This role involves coordinating care with members, PCPs, and IPAs to provide continuous quality care and assist in the...

About Inland Empire Health PlanInland Empire Health Plan (IEHP) is a non-profit health plan serving over 1 million members in Riverside and San Bernardino counties. We are committed to providing high-quality, patient-centered care and improving healthcare and wellness in our communities.Job SummaryWe are seeking an experienced Registered Nurse to join our...

Job Overview">The Clinical Compliance Principal role at Blue Shield of California is a strategic position that oversees the development and maintenance of audit playbooks for regulatory compliance across multiple lines of business. This requires strong engagement with internal and external stakeholders to adapt to changing compliance requirements and manage...

Job OverviewWestern Technologies, Inc. is a leading consulting firm specializing in Construction Materials Testing & Inspection. As a Senior Materials Engineer, you will play a critical role in ensuring the quality and compliance of construction materials through comprehensive testing and inspection services.Key ResponsibilitiesPrepare and review materials...

Job SummaryAs a Power Systems Specialist at Leaf Engineers, you will be responsible for designing electrical distribution systems, power systems, and lighting systems for commercial and educational facilities. You will work closely with clients, vendors, contractors, architects, and electrical engineers to ensure that all designs meet applicable standards...

About the Role: Western Technologies, Inc. is a leading consulting firm in the southwestern United States, specializing in geotechnical engineering, environmental engineering, and construction materials engineering and testing. We are seeking a highly skilled Construction Materials Project Manager to join our team in Rancho Cucamonga.As a key member of our...

About the RoleWe are seeking a Commercial Electrical Engineer to join our team at Leaf Engineers. As a key member of our engineering team, you will be responsible for designing electrical distribution systems, power systems, and lighting systems for commercial and educational facilities. You will work closely with clients, vendors, contractors, architects,...

About the JobiLink Business Management seeks an experienced Payroll Assistant to join our team. In this role, you will be responsible for managing payroll operations, including data entry, record-keeping, and compliance with regulatory requirements.Key Responsibilities:Enters payroll data accurately and efficiently, using financial software to process...

Job DescriptionWe are seeking a highly skilled Land Development Assistant Project Manager to join our team at Blue Engineering and Consulting, Inc.The successful candidate will be responsible for leading the development of construction documents for private development projects while working in a team-oriented setting.ResponsibilitiesCoordinate with project...