A company is looking for a HEDIS Senior Clinical Quality Analyst - REMOTE.Key ResponsibilitiesManage the referrals process, including incoming and outgoing referrals and prior authorizationsOversee the intake process to ensure timely notification of referralsCollaborate with team members and other departments for seamless operationsRequired QualificationsClinical licensure required : RN, LPN, or LVNMinimum of 3 years of HEDIS / medical record review experienceMinimum of 3 years in the healthcare / health plan industryExperience with abstraction and overreadProficient in Microsoft Office applications
HEDIS Senior Clinical Quality Analyst
A company is looking for a HEDIS Senior Clinical Quality Analyst - REMOTE. ...
Senior Quality Assurance Analyst
Participate in code reviews to ensure quality and adherence to standards. ...
Senior Claims Quality Analyst
Claims Quality Assurance Analyst to drive operational efficiencies and improve claim handling. ...
Clinical Disability Quality Analyst- RN required
In addition to performing the duties of a Quality Analyst, the Clinical Quality Analyst ensures the accuracy and adequacy of clinical content and serves as a resource for non-medically trained QAs. If you are passionate about clinical quality and enjoy working in a collaborative and dynamic environm...
Senior Analyst, Healthcare Quality Management - Must live in KS, LA, VA, TX, or IL
This Senior Analyst, Healthcare Quality Management will be a Quality Practice Liaison who builds positive relationships between Aetna Better Health (ABH) and its providers to facilitate high quality care for members. The Quality Practice Liaison is responsible for providing education related to Nati...
Senior Staff Registered Nurse- Clinical Ops-League City
Responsibilities for this position may include but are not limited to leading department clinical activities assessing department needs related to practice and improvement opportunities serving as a clinical resource for department staff and coordinating department education in partnership with mana...
Wealth Management, Marcus by Goldman Sachs, Fraud & Disputes Quality Assurance - Senior Analyst - Richardson, TX
Join our dynamic Controls Assurance and Analytics team at Marcus by Goldman Sachs as a Senior Fraud & Disputes Quality Assurance Analyst. Play a pivotal role in exercising overseeing the quality assurance of dispute resolution and Reg E compliance processes within the Consumer Banking division at Ma...
Senior Staff Registered Nurse- Clinical Ops-LeagueCity
Responsibilities for thisposition may include but are not limited to leading departmentclinical activities assessing department needs related to practiceand improvement opportunities serving as a clinical resource fordepartment staff and coordinating department education inpartnership with managemen...
Clinical Quality Analyst
Pride Health is hiring Clinical Quality Analysts for our top Healthcare Insurance company! This team helps assist with the HEDIS data collection cycle. Overread medical records for HEDIS measures. Attend team meetings to provide information relating to clinical reviews. One plus year HEDIS / medical...
Senior Staff Registered Nurse- Clinical Ops-League City
Responsibilities for this position may include but are not limited to leading department clinical activities assessing department needs related to practice and improvement opportunities serving as a clinical resource for department staff and coordinating department education in partnership with mana...