FULL_TIME

FEED

UNKNOWN

This role focuses on proactive patient outreach, care coordination, patient education, and collaboration with Primary Care Physician, clinical and quality teams to close care gaps, improve preventive and chronic care compliance, and support quality improvement initiatives across Medi-Cal, Medicare, and Commercial populations. Coordinate closely with Primary Care Provider (PCP) offices to schedule appointments for preventive services, chronic care follow-ups, and quality-related visits.

HOUR

Family Choice Aco LLC

Bilingual Patient Engagement Coordinator

The Manager role is in office with travel requirements to local clinics and communities (e.g., for market leader meetings, in-clinic case rounds, team member shadowing/coaching, home visit ride-along) and to preferred healthcare facilities in the community, alongside clinical market leader, to develop clinical partnerships for timely access to patient information, clinical collaboration on patient care, and patient centered resources. The Care Integration Team Manager is responsible for managing a team of nurses, care coaches, and social workers (referred to as “Care Integration Team or CIT) who engage high needs patients using an interdisciplinary team-based approach to ensure patients receive the individualized care and services they need to reach optimal health.

CenterWell

Manager, Clinical Care Integration

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This includes coordinating across primary care (PCP) offices and specialty networks, managing electronic prescription requests and pharmacy communications, driving referral workflows, and tracking durable medical equipment (DME), home health care, imaging, and laboratory orders through completion. Tech-Savvy Learner: Quick to adopt and navigate modern tech tools, dual-monitor workflows, electronic health records, Google Workspace (Sheets, Docs), AI-assisted documentation tools, CRM platforms (e.g., Salesforce), and automated telephony/dialer systems.

Devoted Health Services

Clinical Associate - Medical Assistant

As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. Spend a portion of time clinically-focused on direct patient care, with the remaining time dedicated to administrative duties related to oversight of clinical provision of care including, but not limited to: Working collaboratively with Market CMO and Operational Leadership to: Advance the Model of Care.

YEAR

Physician Lead

IRecruitee

Clinical Associate - Palliative Care

The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going — all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience.

Routine Primary Care APP (NP/PA)- Telehealth

Work requires periods of standing, sitting, lifting, turning, twisting, walking, pushing, pulling, reaching, speaking, hearing, seeing and ability to articulate clearly. MAJOR POSITION RESPONSIBILITIES AND FUNCTIONS: The HIV Advanced Practice Provider will provide medical services, including primary care, to HIV+ patients in.

East Valley Community Health Center

HIV Advanced Practice Provider (Np/Pa)- (Part-Time)

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Under the supervision of the Senior Director of Integrated Case Management (ICM), the Director of ICM (Medicare) provides clinical and administrative oversight for the Medicare Advantage and Integrated Benefits for Dually Eligible ("IB-Dual") populations, also known as the Medicare dual eligible special needs plan (D-SNP) line of business. Provides clinical support for the review of Quality-of-Care concerns being investigated by the Quality Management Department, and collaborates with Quality Management on HEDIS, STAR ratings and CAHPS score improvement initiatives and strategies.

Metroplus Health Plan Inc

Director of Integrated Care Management (Medicare)

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The Manager role is in office with travel requirements to local clinics and communities (e.g., for market leader meetings, in-clinic case rounds, team member shadowing/coaching, home visit ride-along) and to preferred healthcare facilities in the community, alongside clinical market leader, to develop clinical partnerships for timely access to patient information, clinical collaboration on patient care, and patient centered resources. The Care Integration Team Manager is responsible for managing a team of nurses, care coaches, and social workers (referred to as "Care Integration Team or CIT) who engage high needs patients using an interdisciplinary team-based approach to ensure patients receive the individualized care and services they need to reach optimal health.

Humana Inc

Completes on-site provider visits to implement work plans and conduct provider education sessions regarding appropriate coding practices and chart documentation. As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

HF Management Services

Clinical Quality Manager

What makes an Optum career different: Be part of a best-in-class employee experience that enables you to practice at the top of your license We believe that better care for clinicians equates to better care for patients We are influencing change collectively on a national scale while still maintaining the culture and community of our local care organizations Practice medicine autonomously, with the support, not restrictions, of a sustainable and thriving national health care organization. Preferred qualifications: Experience managing complex, high-acuity or medically frail populations preferred Strong clinical judgment with ability to manage complexity independently Team-based care collaboration and communication Comfort with value-based care, quality metrics, and documentation accuracy Interest in longitudinal care management and population health.

Genoa Telepsychiatry

Neighborhood Physician - Primary Care (High Acuity) - Optum | Vegas, Nevada

Spend a portion of time clinically-focused on direct patient care, with the remaining time dedicated to administrative duties related to oversight of clinical provision of care including, but not limited to: Working collaboratively with Market CMO and Operational Leadership to: Advance the Model of Care. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients.

Work requires periods of standing, sitting, lifting, turning, twisting, walking, pushing, pulling, reaching, speaking, hearing, seeing and ability to articulate clearly. Perform timely documentation/action within Electronic Health Record (EHR) including but not limited to, diagnosis, treatment plan, orders, medications, etc.

EVCHC Website

HIV Advanced Practice Provider (NP/PA)- (Part-time)

Advanced Analytics & Suspecting Engine Governance: Suspecting Models: Partner with Healthcare Data Analytics teams to optimize "suspecting engines" that evaluate historic claims, prescription data, lab results, and social determinants of health (SDOH) to predict undocumented or under-documented chronic illnesses. Operating within a network structure comprised of independent, Fee-for-Service (FFS) practices and delegated Independent Physician Associations (IPAs), this Director leads programs such as in-home and virtual assessments, pre-visit suspecting, point-of-care documentation supports, and concurrent validation.

Inland Empire Health Plan

Director, Risk Adjustment Prospective Programs

[AW]-iCims

Under the general direction of the Manager and Supervisor in the Integrated Transitional Care department, the Coordinator - Integrated Transitional Care is a high paced position that requires timely processing of Authorization requests, verifying eligibility, obtaining additional information as requested by the Integrated Transitional Care Nurse. Work Model Location: Word processing and data entry involving computer keyboard and screens, distribution of reports, filing and copying of records and/or correspondence.

Coordinator - Integrated Transitional Care (Short-Term Assignment)

Code, abstract and conduct charge quality review on all episodes of care on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC),observation (OBS) and/or inpatient OB/newborn hospital and specialty clinic encounters according to coding conventions, guidelines and hospital policy, analyzing questionable documentation to ensure to the accuracy of information and resolves identified issues. The primary purpose of the Coding Specialist II is to code and verify charge data necessary to ensure correct coding, abstracting and billing on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC),observation (OBS), specialty clinics and/or inpatient OB/newborn encounters.

Parkland Hospital

Coding Specialist II

OTHER

Collaborates with hospital physicians, medical directors, primary care physicians and nurse case managers in daily activities and initiatives to improve the health of the population, the quality and experience of care our members receive, and lower the overall cost of care at the population level. The Medical Director -BH per diem will support the staff of the Office of Clinical Affairs and Behavioral Health teams in the areas of medical management daily medical necessity reviews, evaluation of medical policy, utilization trend management, quality, appeals and grievances, and pharmacy reviews.

WellSense Health Plan

BH Medical Director (Per Diem)

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Collaborates with hospital physicians, medical directors, primary care physicians and nurse case managers in daily activities and initiatives to improve the health of the population, the quality and experience of care our members receive, and lower the overall cost of care at the population level. Job Summary: The Medical Director -BH per diem will support the staff of the Office of Clinical Affairs and Behavioral Health teams in the areas of medical management daily medical necessity reviews, evaluation of medical policy, utilization trend management, quality, appeals and grievances, and pharmacy reviews.

Well Sense Health Plan Inc

Parkland Health

We are seeking a highly organized and detail-oriented Quality Improvement Assistant to provide clinical and administrative support for the HEDIS Medical Records Review Project. The successful candidate will have strong computer processing skills, experience handling clerical tasks, and a proactive approach to internal and external customer service.

Hedis Review Nurse Jobs in the United States

Bilingual Patient Engagement Coordinator Family Choice Aco LLC

Manager, Clinical Care Integration CenterWell

Clinical Associate - Medical Assistant Devoted Health Services

Physician Lead CenterWell

Clinical Associate - Palliative Care Devoted Health Services

Routine Primary Care APP (NP/PA)- Telehealth Devoted Health Services

HIV Advanced Practice Provider (Np/Pa)- (Part-Time) East Valley Community Health Center

Director of Integrated Care Management (Medicare) Metroplus Health Plan Inc

Manager, Clinical Care Integration Humana Inc

Clinical Quality Manager HF Management Services

Neighborhood Physician - Primary Care (High Acuity) - Optum | Vegas, Nevada Genoa Telepsychiatry

Physician Lead Humana Inc

HIV Advanced Practice Provider (NP/PA)- (Part-time) EVCHC Website

Director, Risk Adjustment Prospective Programs Inland Empire Health Plan

Coordinator - Integrated Transitional Care (Short-Term Assignment) Inland Empire Health Plan

Coding Specialist II Parkland Hospital

BH Medical Director (Per Diem) WellSense Health Plan

BH Medical Director (Per Diem) Well Sense Health Plan Inc

Coding Specialist II Parkland Health

Quality Improvement Assistant emergiTEL HR Solutions

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