• Fully Remote Hedis Specialist

    TEKsystems (Austin, TX)
    TekSystems is currently hiring for several FULLY REMOTE Hedis Specialists that can start January 1 and interview ASAP! MUST HAVE: 2-3 years of Hedis ... Texas is fine as it will still be fully remote ! Description Remote TX Target Start Date...schedule (OT requirements) 8-5 (OT available as needed) The HEDIS non-clinical team falls under the Quality Improvement Department… more
    TEKsystems (10/31/25)
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  • Remote HEDIS Specialist

    TEKsystems (Austin, TX)
    Job Posting: Quality Improvement Specialist - HEDIS Non-Clinical ( REMOTE ) Start Date: 5 January 2026 (Trainer already assigned - hard start) Duration: 3 ... 8:00 AM-5:00 PM CST (OT available as needed) Location: Remote (Texas-based role) Department: Quality Improvement, Superior HealthPlan Position Overview… more
    TEKsystems (10/31/25)
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  • HEDIS Specialist ( Remote

    TEKsystems (Dallas, TX)
    HEDIS Specialists Start Date: January 5th 2026 Interviewing ASAP! Anticipated contract duration through April with potential for extension! Schedule: 8am-5pm (OT ... and provider addresses, and/or collect medical records for the HEDIS project + Data entry of change of addresses...or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to… more
    TEKsystems (10/31/25)
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  • Senior Specialist , Member & Community…

    Molina Healthcare (OH)
    **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements new and existing clinical quality member intervention ... improvement of intervention processes and outcomes. Acts as a lead specialist within the department and/or collaboratively with other departments. Please include… more
    Molina Healthcare (10/19/25)
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  • Specialist , Member & Community…

    Molina Healthcare (OH)
    **Job Description** **Job Summary** The Specialist , Member & Community Interventions implements new and existing clinical quality member intervention initiatives ... critical program milestones, deadlines, and/or deliverables + Participates in quality/ HEDIS improvement activities, meetings, and discussions with and between other… more
    Molina Healthcare (09/21/25)
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  • Senior Specialist , Provider Engagement…

    Molina Healthcare (Worcester, MA)
    **Job Description** **Job Summary** The Sr Specialist , Provider Engagement role implements Health Plan provider engagement strategy to achieve positive quality and ... risk adjustment outcomes through effective provider engagement activities. Ensures the core set of Tier 2 providers in the Health Plan have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to… more
    Molina Healthcare (10/18/25)
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  • HEDIS - Quality Improvement…

    TEKsystems (Dallas, TX)
    Quality Improvement Specialist Contract - 3 month w/potential for extension or to go permanent Must be a Resident of Texas Job Description The Quality Improvement ... Specialist will support the development and maintenance of quality...and provider addresses, and/or collect medical records for the HEDIS project + Data entry of change of addresses… more
    TEKsystems (10/31/25)
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  • Senior Specialist , Quality Program…

    Molina Healthcare (Davenport, IA)
    **Job Description** **Job Summary** The Senior Specialist , Quality Program Management and Performance implements new and existing healthcare quality improvement ... and monitoring for key quality program activities. Acts as a lead specialist to provide project, program, and/or initiative related direction. Provides guidance for… more
    Molina Healthcare (11/01/25)
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  • Senior Specialist , Quality…

    Molina Healthcare (Chicago, IL)
    …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Interventions / QI Compliance contributes to one or ... Quality Interventions and Quality Improvement Compliance. + Acts as a lead specialist to provide project-, program-, and / or initiative-related direction and… more
    Molina Healthcare (10/18/25)
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  • Senior Medical Coding Specialist

    CareFirst (Baltimore, MD)
    …and contributes to thought leadership for quality measure capture (NCQA, HEDIS , STARs). Collaborates with internal stakeholders on process and outcome improvement ... data collection tools. **Licenses/Certifications Upon Hire Required:** + CCS-Certified Coding Specialist + Certified Coder (CCS or CPC)-AHIMA or AAPC Salary Range:… more
    CareFirst (09/27/25)
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  • Quality Improvement Specialist

    TEKsystems (Austin, TX)
    Quality Improvement Specialist 100% Remote within the State of Texas only! Description: The HEDIS non-clinical team falls under the Quality Improvement ... in Texas. Most of our projects center on monitoring HEDIS rates all throughout the year, medical record retrieval,...chases to the health plan for resolution. The QI Specialist will resolve these "pends" and ensure that we… more
    TEKsystems (10/31/25)
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  • Quality Performance Specialist

    AmeriHealth Caritas (Manchester, NH)
    **Role Overview:;** The Quality Performance Specialist is responsible for the coordination and ongoing monitoring of Quality Improvement (QI) program objectives, ... all departments, and facilitating Healthcare Effectiveness Data & Information Set ( HEDIS ), Consumer Assessment of Healthcare Providers & Systems (CAHPS) and National… more
    AmeriHealth Caritas (09/12/25)
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  • Senior Medical Record Retrieval Operations…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …of Minnesota Position Title: Senior Medical Record Retrieval Operations Specialist Location: Hybrid | Eagan, Minnesota Career Area: Customer Service/Operations ... Shield of Minnesota is hiring a Senior Medical Record Retrieval Operations Specialist . This position supports the team with primary accountabilities related to… more
    Blue Cross and Blue Shield of Minnesota (10/23/25)
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  • Quality Management Specialist

    UPMC (Pittsburgh, PA)
    …Specialists! This position involves extensive travel throughout Pennsylvania, with remote work available during non-travel periods. Candidates may reside in ... within 2 hours of a CCBH office location. The Quality Management Specialist is responsible for performing functions related to quality management and improvement,… more
    UPMC (09/27/25)
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  • Quality Perform Specialist Clinical

    AmeriHealth Caritas (Columbia, SC)
    …also include supporting the annual medical record review activities including HEDIS and, Clinical Practice Guidelines. The position also supports accreditation and ... ; ;It support the Foster care team.; **Work Arrangement** This position is Remote but must live in South Carolina. ;For internal candidates, bordering states may… more
    AmeriHealth Caritas (10/28/25)
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  • BH Care Manager LCSW or LMHC Remote in New…

    Molina Healthcare (NY)
    …BH services/resources and community supports is highly preferred. Skilled in closing HEDIS and preventive care gaps through proactive outreach and coordination with ... and health equity principles. Case management and managed care experience is highly preferred. Remote position based in New York A New York LCSW or LMHC licensure is… more
    Molina Healthcare (10/22/25)
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  • Market CMO, Centerwell Senior Primary Care…

    CenterWell (Phoenix, AZ)
    …+ Oversee daily operations of physician services. + Build strong relationship with specialist , hospitalist, SNF and other providers to form a narrow network of ... Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice...Off/Holidays + Minimal call Travel: While this is a remote position, occasional travel to Humana's offices for training… more
    CenterWell (10/24/25)
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