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Job Summary:The Nurse Care Manager is responsible for helping coordinate and evaluate the management of patients with acute and chronic conditions, across the care continuum, to achieve high quality care measured by positive patient outcomes. In our medical clinics, we provide comprehensive primary care for senior adults with traditional Medicare and Medicare Advantage plans, focused on delivering improved quality, better patient experience and lower total cost of care.

ArchWell Health

RN Care Manager - FGC

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The Lead reviews and determines status for delegated inpatient and SNF admissions, owns post-discharge transitions for members leaving those facilities, and carries the complex case management caseload for high-risk members, including direct member and caregiver outreach. Carry the complex case management caseload for high-risk members: identify and enroll eligible members, complete comprehensive assessments, and develop individualized, patient-centered care plans in collaboration with the Medical Director and treating providers.

Akido

Utilization Management Lead — Inpatient Case Management (RN)

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A respected healthcare organization in Midtown Manhattan is seeking an experienced Wellness QA Nurse Manager (RN) to lead quality improvement initiatives, support provider collaboration, and drive better patient outcomes across diverse populations. This is an excellent opportunity for a strong clinical leader who understands HEDIS, quality metrics, population health, and team mentorship — while remaining hands-on in improving care delivery.

HOUR

We stand for PERSEVERANCE, as we refuse to quit when the journey gets tough. Your gold is our mission, and we search day and night to find it.

Phaxis LLC

Wellness QA Nurse Manager Wellness

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Demonstrates understanding and working knowledge of key elements of Risk Adjustment Factor (RAF) and Hierarchical Condition Categories (HCC) model within 30 days of hire Demonstrates understanding and working knowledge of key elements of Quality STAR/HEDIS measures within 30 days of hire Rotation of telephonic on call coverage after hours. The ideal candidate for this role demonstrates a high level of clinical expertise in working with members with acute and chronic conditions and is responsible for assessment, diagnosis, treatment, plan, management, education, health promotion and care coordination for member health needs.

Arkos Health

Nurse Practitioner

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NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. The process includes case identification, case opening, member assessment, education and support intervention opportunities, developing care plans, conducting member-centric interventions, measuring member outcomes during re-assessment, case closure, and case reviews.

Lifetime Workforce Solutions

Case Manager, RN (Multiple Openings!)

Nurse Practitioner PRN

Active, non-restricted compact state nursing license with primary state of licensure in one of the following: Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Guam, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, Wisconsin, or Wyoming. Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds.

Fuze Health

Registered Nurse

As an integral part of the HEDIS HOS Intervention Team within Clinical Quality and Compliance, you will coordinate and collaborate with teams and associates inside and outside of HMM, including Care Management, Member and Provider Service, and Performance Measurement and Improvement. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

Blue Cross and Blue Shield of Massachusetts Inc

Nurse Health Coach

Perform routine medical tasks within the scope of license: Administers individual nursing care, independently and skillfully applying both simple and complex techniques and processes that are specific to the needs of the patient including I.V. catheter insertion, phlebotomy, electrocardiograms, urinalysis, pregnancy testing and laboratory tests, and other testing as directed by the medical provider. Maintain the cleanliness and general appearance of work, examination, and treatment areas; clean, disinfect, sterilize, and maintain equipment and instruments following universal precautions, infection control and hazardous waste removal practices.

Alcona Health Center

Site Support Staff

Working under the Medical Assistant Supervisor and in collaboration with clinical nursing leadership, the Medical Assistant supports daily clinical operations and partners with clinical, behavioral health, nutrition, integrated care, community health, referral, and front office teams to improve access, patient engagement, quality outcomes, and overall patient experience. Physical demands: While performing the duties of this job, the employee may be required to sit for long periods of time, is required to stand, walk, use hands to handle or feel objects, tools or controls; reach with hands and arms; climb steps/stairs; balance; stoop, kneel, crouch or crawl; talk or hear; smell; manage stress as it relates to essential job functions.

ADELANTE HEALTHCARE, INC.

Medical Assistant

PrimaryOne Health's commitment to high-quality service, personal patient care, and access to state-of-the-art technology enables us to remain the fastest growing urban health center in Central Ohio. Our patients have access to primary healthcare, dental and vision services, nutrition planning, diabetes education, and other specialty medical services for the entire family within their own neighborhood.

Columbus Neighborhood Health Center Inc

Quality Improvement Specialist

The Population Health Specialist utilizes population health tools, patient registries, quality reports, and outreach workflows to support HEDIS, STAR, risk adjustment, Annual Wellness Visits, and other quality initiatives while contributing to organizational performance and patient health outcomes. The Population Health Specialist supports Akido’s value-based care strategy by identifying, engaging, and coordinating care for patient populations requiring preventive services, chronic disease management, and care gap closure.

Population Health Specialist

Under general direction, performs professional work with the development and implementation of clinical process redesign and information flow as it relates to the implementation and ongoing support of the Riverside University Health System (RUHS) integrated clinical information systems and healthcare applications; assists the Clinical Integration Supervisor in coordinating clinical work flow assignments through all phases of the Electronic Health Record (EHR) and clinical systems development, implementation, support, and modification/update; performs other related duties as required. Facilitate effective communication with user groups and assist with go-live readiness to ensure smooth implementation of new functional elements, applications, and major releases of clinical information systems; interface with researchers related to the development implementation and review of the RUHS clinical information systems and procedures aiming to create a mechanism for automation data abstraction from the EMR (EPIC) in support of the research projects.

YEAR

County of Riverside, California

Clinical Integration Analyst - Riverside University Health Systeem (Clinical Informatics)

Qualifications and Skills: High school diploma or GED equivalent required Must have their own reliable vehicle to drive out in the field to patients homes Must have valid state driver license and appropriate liability insurance Certified Nurse Assistant (CNA) Certification or Medical Assistant (MA) Current CPR required 2+ years experience in a healthcare environment Ability to perform point-of-care testing such as urine sample collection, A1c checks, blood pressure checks Familiar with medical terminology Excellent written and verbal communication, relationship-building, and problem-solving skills Highly organized and able to prioritize ones own workload Strong customer service skills with exceptional attention to detail Proficient with Microsoft Office Previous experience using EMR systems would be an advantage. Essential Duties and Responsibilities: This position is responsible for performing in-home visits with patients Review data collected to confirm gaps in care are captured Build positive, professional relationships with the patients we serve Explain point-of-care testing and reasoning to patients Demonstrate excellent communication and collaboration skills This is both an in-office/field position: candidate must be comfortable traveling up to 80% of the time.

Quality Coordinator (MA/CNA)

Physicians, nurse practitioners, physician assistants, physical therapists, pharmacists, social workers, psychologists, specialized technicians, and nurses work together while intentionally integrating health care students, residents, and fellows to deliver care to our community. The Coding and Documentation Specialist is responsible for reviewing clinical documentation and coding to ensure services are accurately documented, coded, and submitted in accordance with federal, state, payer, and organizational requirements.

UNIVERSITY OF NORTH TEXAS SYSTEM

Coding and Documentation Specialist

Excellent interpersonal and customer service skills, to effectively and tactfully deal with a diverse group of patients, staff, customers, and community groups. Ensures that all Information Systems are operational to ensure functional systems with computers, telephone systems and software programs with relation to clinic operations.

Hamilton Community Health Network

OPERATIONS MANAGER

License and DEA must be active, in good standing, and verifiable with the proper regulatory agency; Primary Care Providers must be able to treat all ages and must meet any credentialing requirements needed; and DOT certification required to be obtained within 120 days of employment and maintained during employment. They must have the ability to respond quickly and accurately to changes in condition or response to treatment and is responsible for providing outstanding patient service within the clinic and through various virtual communication channels, while maintaining a compassionate and welcome atmosphere.

Fast Pace Health

Primary Care Provider: Nurse Practitioner or Physician Assistant

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Or in select states, Master of Science in Physician Assistant Studies (or other health-related Master's Degree or equivalent experience together with Bachelor of Science in Physician Assistant Studies) with current National Board Certification and State of Employment license to practice in the role. Work in partnership with the Senior and Field Educators, and Senior Clinicians to ensure effective programs for provider training, education and development.

<p>CVS Health offers a world of promising job opportunities across a diverse range of careers in everything from corporate and pharmacy roles to retails positions. No matter where you work at CVS Health, your unique skills, talents and abilities are welcome and valued. We recognize and reward greatness and want our employees to know their work is making a difference in the lives of millions. Join us today. Together we can continue making innovative, high-quality health and pharmacy services safe, affordable and accessible – for all. </p>

CVS Health

Senior Practice Clinical Manager - NP/PA

Appcast PX 2

Perform clinical interventions as appropriate and at the direction of the overseeing provider, including medication administration (PO, SL, IM, IV), wound care, point-of-care testing, phlebotomy, Foley catheter care, IV fluid administration, and other approved nursing procedures. We are seeking a highly skilled, compassionate Registered Nurse (RN) to deliver high-quality, patient-centered care through a combination of in-home patient visits, telehealth patient consults with Nurse Practitioners or Physicians as required, and administrative tasks.

WellBe Senior Medical

CareConnect Registered Nurse (RN) - In Home Medical Care Willoughby, OH

This position is responsible for National Committee for Quality Assurance Healthcare Effectiveness Data and Information Set's (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) initiatives, including leading all aspects of training, implementation and reporting of medical record retrieval, review (MRR) and overread. Leads MRR and related HEDIS compliance audit deliverables, Oversees and performs project management of assignments from beginning to end establishing timelines, coordinating, monitoring, troubleshooting, summarizing, and reporting on project deliverables.

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry.  We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

Hedis Review Nurse Jobs in the United States

RN Care Manager - FGC ArchWell Health

Utilization Management Lead — Inpatient Case Management (RN) Akido

Wellness QA Nurse Manager Wellness Phaxis LLC

Nurse Practitioner Arkos Health

Case Manager, RN (Multiple Openings!) Lifetime Workforce Solutions

Nurse Practitioner PRN Arkos Health

Registered Nurse Fuze Health

Nurse Health Coach Blue Cross and Blue Shield of Massachusetts Inc

Site Support Staff Alcona Health Center

Medical Assistant ADELANTE HEALTHCARE, INC.

Quality Improvement Specialist Columbus Neighborhood Health Center Inc

Population Health Specialist Akido

Clinical Integration Analyst - Riverside University Health Systeem (Clinical Informatics) County of Riverside, California

Quality Coordinator (MA/CNA) Arkos Health

Coding and Documentation Specialist UNIVERSITY OF NORTH TEXAS SYSTEM

OPERATIONS MANAGER Hamilton Community Health Network

Primary Care Provider: Nurse Practitioner or Physician Assistant Fast Pace Health

Senior Practice Clinical Manager - NP/PA CVS Health

CareConnect Registered Nurse (RN) - In Home Medical Care Willoughby, OH WellBe Senior Medical

Lead HEDIS Specialist - Hybrid Blue Cross and Blue Shield Association

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