• Lead Overreader, HEDIS /Quality Improvement…

    Molina Healthcare (Columbus, OH)
    …oversight and audits of the data collected and abstracted from medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The Lead ... standards as well. Lead Overreader mentors and trains new team members. Leads special HEDIS /Quality projects. **Job Duties** + Performs the lead role of the HEDIS more
    Molina Healthcare (04/22/25)
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  • 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 (04/20/25)
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  • Lead Overreader, HEDIS Abstraction…

    Molina Healthcare (Columbus, OH)
    …oversight and audits of the data collected and abstracted from medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The Lead ... as well. Lead Overreader mentors and trains new team members. Leads special HEDIS /Quality projects. **We are seeking strong experience in HEDIS abstraction and… more
    Molina Healthcare (04/11/25)
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  • HealthCare HEDIS Reporting Lead

    AmeriHealth Caritas (Newtown Square, PA)
    …. ;** This is a remote position. ; Previous experience with full HEDIS Road Map and life cycle, SQL skills and previous management experience.; **Responsibilities:** ... Implements Healthcare Effectiveness Data and Information Set ( HEDIS ) project plan and meets all requirements of ;National Committee for Quality Assurance ( NCQA) and… more
    AmeriHealth Caritas (04/24/25)
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  • HEDIS Abstractor II (Temporary)

    LA Care Health Plan (Los Angeles, CA)
    HEDIS Abstractor II (Temporary) Job Category: Clinical Department: Quality Performance Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... that purpose. Job Summary The Healthcare Effectiveness Data and Information Set ( HEDIS ) Abstractor II reviews medical records to ensure completeness, compliance with… more
    LA Care Health Plan (04/09/25)
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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 (02/05/25)
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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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  • Stars Program Delivery Lead - HEDIS

    Humana (Columbus, OH)
    …of in office and work at home) Apply in-depth and broad knowledge of HEDIS measures to develop strategy and implement comprehensive solutions to drive overall Stars ... and willing to learn the more minute parts of HEDIS measures and gap closure processes with limited guidance...management and/or strategy experience + 2+ Medicare Stars and HEDIS knowledge or experience + Superb communication skills, written… more
    Humana (04/24/25)
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  • Lead, Data Quality/Integrity - HEDIS

    Humana (Columbus, OH)
    …deployment of data focused enhancements and functionality. + Partner with internal HEDIS operations and compliance teams on the maintenance of policies, processes, ... and procedures in support of the annual HEDIS roadmap. + Support annual standard and nonstandard supplemental...in provider engagement, MRA or STAR + Familiarity with HEDIS measures **Additional Information** As part of our hiring… more
    Humana (04/24/25)
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  • Quality/ HEDIS Coordinator (Member…

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …adherence measures. This includes conducting outbound calls to members to close HEDIS gaps in care, discussing the importance of medication adherence, contacting ... calls to members to encourage medication adherence, support prescription refills, and close HEDIS gaps in care. + Educate members on the importance of taking… more
    DOCTORS HEALTHCARE PLANS, INC. (04/26/25)
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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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  • 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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  • Senior Analytic Data Analyst - FEP HEDIS

    Highmark Health (Columbus, OH)
    …development and deployment of analytics to assist in the betterment of HEDIS Quality performance improvement. The incumbent cleanses, validates, audits, and compares ... data from various sources. Provides business process and industry domain knowledge to projects while working with engineering and business teams on requirements and outcomes. The incumbent delivers data profiling, conducts testing and systems validation to… more
    Highmark Health (03/13/25)
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  • Quality Practice Advisor - Medical Affairs

    Centene Corporation (Houston, TX)
    …benefits including a fresh perspective on workplace flexibility. **Applicants with HEDIS measures and Medicare STAR Ratings experience** **Work Location: Houston, ... provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures,… more
    Centene Corporation (04/27/25)
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  • Manager, Performance Quality Improvement

    Centene Corporation (Jefferson City, MO)
    …Assurance (NCQA) and Healthcare Effectiveness Data and Information Sets ( HEDIS ) performance improvement projects. + Oversee quality improvement related activities ... (ie outcome studies, QI projects) + Coordinate ongoing data management for HEDIS and QI project management databases. Evaluate sources for alternative data capture,… more
    Centene Corporation (04/27/25)
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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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  • Manager, Clinical Quality Improvement

    VNS Health (Manhattan, NY)
    …+ Leads the clinical audit team, ensuring compliance with Medicare STARS, HEDIS /QARR, and regulatory requirements. + Develops forms, record abstracts, reports, and ... accuracy, documentation, and quality reporting to improve STARS and HEDIS scores. + Acts as the primary clinical liaison...for IPAs and provider networks, ensuring alignment with STARS, HEDIS , and clinical quality objectives. + Works closely with… more
    VNS Health (03/13/25)
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  • Clinical Quality Management Analyst

    BlueCross BlueShield of North Carolina (NC)
    …quality improvement for NCQA Healthcare Effectiveness and Data Information Set ( HEDIS ) measures, MA Stars and developing improvement plans when needed. Implement ... to streamline processes related to Healthcare Effectiveness Data and Information Set ( HEDIS ) measures to maximize outcomes of NCQA accreditation, Medicare Stars, … more
    BlueCross BlueShield of North Carolina (04/28/25)
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