• Supervisor, HEDIS

    Centene Corporation (Columbus, OH)
    …workplace flexibility. **Position Purpose:** Supervise and coordinate team ensure HEDIS data accuracy and reporting, including investigations, auditing, and ... opportunities. Collaborate with internal and external stakeholders to ensure HEDIS and CAHPS initiatives are fully integrated throughout the organization,… more
    Centene Corporation (06/08/25)
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  • Manager HEDIS Reporting

    AmeriHealth Caritas (Newtown Square, PA)
    SQL and HEDIS ;experience is required to be considered for this position. ; Remote position working East Coast hours.; Manages Healthcare Effectiveness Data and ... Information Set ( HEDIS ) planning, data collection, quality control, analysis, and reporting...Applying both business knowledge and technical expertise to supports HEDIS strategies, goals, and initiatives at corporate and plan-level.;… more
    AmeriHealth Caritas (06/06/25)
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  • HEDIS Specialist-Health Plan

    BayCare Health System (Clearwater, FL)
    …for ensuring that all healthcare providers are in compliance with the HEDIS measures. + This involves reviewing medical records and other documentation to ... improve their performance and meet the requirements of the HEDIS program. + Additionally, responsible for communicating with patients...patients to help them understand the importance of the HEDIS program and how it impacts their healthcare. +… more
    BayCare Health System (04/23/25)
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  • HEDIS Overreader Registered Nurse

    Insight Global (Philadelphia, PA)
    Job Description A client of Insight Globals is looking for HEDIS (Healthcare Effectiveness Data and Information Set Nursing) RNs or LPNs for a remote contract ... This is a fully remote position and requires previous HEDIS review experience. This person will be responsible for...This person will be responsible for Quality Check of FDC/ HEDIS nurses. This person will use healthcare data and… more
    Insight Global (04/01/25)
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  • HEDIS Reviewer II

    US Tech Solutions (May, OK)
    …outreach, collection, and review of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to the start of the ... in any way possible to complete the screenings. * Search for relevant HEDIS records from databases, review medical records using HEDIS technical specification… more
    US Tech Solutions (05/07/25)
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  • HEDIS Registered Nurse or LPNs (Field…

    Insight Global (Philadelphia, PA)
    Job Description A client of Insight Globals is looking for HEDIS RNs or LPNs for a partially remote contract position in PA and NJ. PARTIALLY remote position as it ... from onsite visit, assigned remote charts Highlighting member demographics & HEDIS evidence using Adobe Acrobat Reader Reviewing Overreads for any corrections… more
    Insight Global (04/01/25)
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  • * HEDIS Reviewer III

    NTT DATA North America (IL)
    HEDIS Reviewer - State of IL Position Summary: Participates in the collection and review of medical records to abstract clinical information for HEDIS quality ... Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance measures. Ensures accurate and complete documentation of required… more
    NTT DATA North America (04/02/25)
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  • HEDIS Quality Outreach Coordinator - Full…

    Emanate Health (Covina, CA)
    …quality measures and surveying patients on simple health questions. The HEDIS Outreach Coordinator will also assist with inputting authorizations, ordering lab ... with managed care, commercial and point of service medical care preferred. HEDIS experience preferred. Computer literate with knowledge and experience with specific… more
    Emanate Health (06/12/25)
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  • Clinical Data Analyst III ( HEDIS

    LA Care Health Plan (Los Angeles, CA)
    Clinical Data Analyst III ( HEDIS , Tableau, SQL) Job Category: Clinical Department: Quality Improvement Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... measures such as those used by National Committee for Quality Assurance (NCQA), HEDIS , Centers for Medicare and Medicaid Services (CMS), and State. Must demonstrate… more
    LA Care Health Plan (04/08/25)
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  • Sr. Specialist, Provider Engagement - HEDIS

    Molina Healthcare (Rochester, NY)
    …**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 improve… more
    Molina Healthcare (06/07/25)
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  • Quality Practice Advisor

    Centene Corporation (Oklahoma City, OK)
    …5PM CENTRAL TIME ZONE. IDEAL APPLICANT WILL BE A NURSE WITH HEDIS BACKGROUND.** **Position Purpose:** Establishes and fosters a healthy working relationship between ... provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures,… more
    Centene Corporation (04/16/25)
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  • Quality Improvement Project Manager

    Centene Corporation (Sacramento, CA)
    …to engage, recommend and support improved coding for direct impact on HEDIS data capture strategies in accordance with National Committee for Quality Assurance ... (NCQA) and Healthcare Effectiveness Data and Information Set ( HEDIS ) standards and specifications. Provide insight and make recommendations to internal stakeholders… more
    Centene Corporation (06/12/25)
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  • Quality Practice Advisor

    Centene Corporation (Little Rock, AR)
    …provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, ... plan compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for...as a resource for the health plan peers on HEDIS measures, appropriate medical record documentation and appropriate coding.… more
    Centene Corporation (06/08/25)
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  • Associate Quality Practice Advisor

    Centene Corporation (Tallahassee, FL)
    …sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record ... deficiencies impacting plan compliance to meet State and Federal standards for HEDIS . + Under general guidance form Senior Quality Practice Advisors and management,… more
    Centene Corporation (06/08/25)
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  • Lead Quality/STARS Technical Analyst- remote…

    Trinity Health (Columbus, OH)
    …Day Shift **Description:** Successful candidates will possess at least 5 years of HEDIS and technical experience. A thorough understanding of NCQA and HEDIS ... relations and more. **About the job:** The Lead Quality/Stars HEDIS and Technical Analyst . Designs and implements processes...required + Experience: Minimum of five (5) years of HEDIS and technical experience + Effective communication skills and… more
    Trinity Health (05/17/25)
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  • Quality Improvement Project Manager

    Centene Corporation (Columbia, SC)
    …Quality Assurance (NCQA) and Healthcare Effectiveness Data and Information Set ( HEDIS ) preparation. + Provide functional and technical knowledge for NCQA/ HEDIS ... constituents as needed. + Coordinate Work Plan, team and resources for HEDIS /Consumer Assessment of Healthcare Providers and Systems (CAHPS) submission to Connector… more
    Centene Corporation (06/13/25)
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  • DSNP Project/Program Manager

    BlueCross BlueShield of North Carolina (NC)
    …as required to redirect activities and attain objectives. + Developing HEDIS project plans. + Cross-departmental collaboration and stakeholder education. + ... Responsible for DSNP HEDIS program management which includes HEDIS Roadmap, production runs, admin refresh, reporting, etc. + Perform compliance related… more
    BlueCross BlueShield of North Carolina (06/04/25)
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  • Senior Analyst, Risk & Quality Reporting (Remote)

    Molina Healthcare (ID)
    …Educates users on how to use reports related to Risk and Quality/ HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion ... + Builds ad hoc reports as requested to track HEDIS performance and supplemental data monitoring + Develops and...QA custom health plan reports related to Risk and Quality/ HEDIS for Medicaid, Marketplace and Medicare/MMP + Develops custom… more
    Molina Healthcare (05/31/25)
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  • Patient Care Advocate

    Centene Corporation (Jackson, MS)
    …group practices. Serves to collaborate with providers in the field, to improve HEDIS measures and provides education for HEDIS measures and coding. Supports ... plan compliance to meeting State and Federal standards for HEDIS . Conducts telephonic outreach, while embedded in the providers'...embedded. + Advises and educates Provider practices in appropriate HEDIS measures, and HEDIS ICD-10 /CPT coding… more
    Centene Corporation (06/15/25)
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  • Clinical Quality LPN

    Adecco US, Inc. (Minneapolis, MN)
    …and Life Sciences is currently recruiting for Remote Clinical Quality LPNs with HEDIS experience. This is a telecommute role. Please read below and apply with ... * Remote data mining in EHR systems to support HEDIS and STARs initiatives * Outreach to provider offices...DataRAP * Acting as a subject matter expert for HEDIS data collection and provider questions * Navigating multiple… more
    Adecco US, Inc. (05/09/25)
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