• HEDIS Retrieval Specialist

    Robert Half Office Team (Minneapolis, MN)
    …Public Health, Nursing, or a related field preferred. + Previous experience in HEDIS data collection, quality improvement , or healthcare analytics is ... Description We are currently hiring seasonal HEDIS support with a large Fortune Healthcare 500...are committed to improving health outcomes and enhancing the quality of care for our members. As a leader… more
    Robert Half Office Team (11/05/24)
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  • HEDIS Reviewer

    Centers Plan for Healthy Living (Garden City, NY)
    …A minimum of three (3) years of experience in the health care industry, in HEDIS and/or quality improvement . Experience in a managed care health services ... Living (CPHL) under the direction of the Director of Quality Management. Responsibilities include, but are not limited to...secure clinical documentation from Primary Care Physician (PCP) and/or Specialist (s) as indicated by HEDIS measures. +… more
    Centers Plan for Healthy Living (11/06/24)
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  • Quality Improvement (RN) - Maternity…

    Molina Healthcare (Ypsilanti, MI)
    …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Improvement (Registered Nurse) contributes ... quality improvements functions: Quality Interventions, Quality Improvement Compliance, HEDIS , and...review of records submitted by providers and the annual HEDIS medical record review. The Senior Specialist more
    Molina Healthcare (10/20/24)
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  • Quality Improvement

    VNS Health (Manhattan, NY)
    …instruments, and conducts quality , compliance and utilization reviews. * Ensures Quality Improvement programs are aligned with CMS Triple Aim framework: ... policies. * Serves as a resource and provides expertise and assistance on quality improvement projects. * Collaborates with clinical management to identify,… more
    VNS Health (10/15/24)
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  • Quality Improvement

    VNS Health (Manhattan, NY)
    …providers or specialist to address non-adherence and/or clinical diagnosis for HEDIS /QARR exclusion. + Participates and leads improvement teams and projects ... OverviewLeads interdepartmental quality improvement activities such as development and engagement, clinical review, clinical risk management, and patient… more
    VNS Health (09/04/24)
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  • Quality Improvement

    Trinity Health (Mishawaka, IN)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** **JOB SUMMARY** The Quality Improvement Specialist assists in the continuous quality ... and organizational excellence of Select Health Network. The Quality Improvement Specialist will have...+ Understands and stays up to date with current HEDIS measures. + Performs other duties consistent with purpose… more
    Trinity Health (10/08/24)
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  • Sr Specialist , Quality

    Molina Healthcare (AZ)
    improvement functions: Quality Interventions and Quality Improvement Compliance. + Acts as a lead specialist to provide project-, program-, ... **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans, and...surveys and federal/state QI compliance activities. **A background in quality / HEDIS is very important for this position.… more
    Molina Healthcare (10/10/24)
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  • Specialist , Quality

    Molina Healthcare (West Seattle, WA)
    …important for this position. Please include any experience in Quality / HEDIS on your application. **KNOWLEDGE/SKILLS/ABILITIES** The Specialist , Quality ... **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans, and...(RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
    Molina Healthcare (10/04/24)
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  • Accreditation Specialist

    Centene Corporation (Austin, TX)
    …degree in Business, related field or equivalent experience. 3+ years of related quality improvement , HEDIS and/or NCQA experience.Pay Range: $54,000.00 - ... a fresh perspective on workplace flexibility. **Position Purpose:** Develop Performance Improvement projects to improve clinical quality and performance measure… more
    Centene Corporation (11/02/24)
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  • Specialist , Provider Engagement (Remote…

    Molina Healthcare (Flint, MI)
    …Min. 3 years' experience in healthcare with 1 year experience in health plan quality improvement ( HEDIS ), managed care or equivalent experience. + ... **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans, and...and monitoring for key performance measurement activities. **Experience with quality , providers and HEDIS is very important… more
    Molina Healthcare (10/18/24)
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  • Senior Population Health Specialist

    Beth Israel Lahey Health (Wakefield, MA)
    …to customer service standards. Participate in departmental and/or interdepartmental quality improvement activities. Participate in and successfully completes ... making a difference in people's lives.** Under the supervision of the Quality Manager, the Senior Population Health Specialist (PHS) supports collaboration,… more
    Beth Israel Lahey Health (11/02/24)
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  • Senior Provider Engagement Specialist

    Molina Healthcare (Seattle, WA)
    …Summary** **This position will be supporting Molina's Washington Health Plan** Molina's Quality Improvement function oversees, plans, and implements new and ... existing healthcare quality improvement initiatives and education programs specific...or Healthcare. **Preferred Experience** + Understanding and experience with Quality and HEDIS measures. + Proficient with… more
    Molina Healthcare (10/27/24)
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  • Clinical Quality Program Specialist

    Elevance Health (KS)
    … Program Specialist ** is responsible for supporting projects and assisting the quality improvement activities and programs for and/or on behalf of the Health ... met within established time frames and budgets. + Assists with compliance of corporate Quality Improvement (QI) work plans. + Supports Clinical Quality more
    Elevance Health (10/11/24)
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  • Provider Network Credentialing Specialist

    Health First (Rockledge, FL)
    …status for organizational providers. 9. Conduct reviews of provider network adequacy for quality improvement evaluation, the National Committee for Quality ... *POSITION SUMMARY* The Provider Network Credentialing Specialist is responsible for coordinating, monitoring and maintaining the credentialing and re-credentialing… more
    Health First (10/25/24)
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  • Clinical Systems/EHR Quality Data…

    US Tech Solutions (Boston, MA)
    …in a meaningful and understandable way. **Experience:** + Experience with quality improvement methodologies preferred. + Strong analytical and problem-solving ... and other healthcare industry metrics used to benchmark performance. + Quality improvement methodologies. **Education:** + Bachelor's degree in health… more
    US Tech Solutions (10/18/24)
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  • Clinical Quality Specialist

    Sanford Health (Worthington, MN)
    …to the quality risk and risk score adjustment programs. Assist with the quality improvement review and audit related to potential quality risk issues ... (CPHQ) or medical coding certification preferred, but not required. Quality improvement /assurance personnel with nursing backgrounds can maintain their… more
    Sanford Health (10/02/24)
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  • Temporary Accounting Specialist II

    ManpowerGroup (Rancho Cucamonga, CA)
    …IEHP's Quality Program goals including, but not limited to, HEDIS , CAHPS, and NCQA Accreditation. **Qualifications:** **Education & Experience** + Three (3) ... **Title: Accounting Specialist II** **Location: Rancho Cucamonga CA (Hybrid)** **Duration:...timeframe. 7. Assist in implementation and maintenance of process improvement activities. 8. Oversee and review data entry, analyze… more
    ManpowerGroup (10/15/24)
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  • Population Health Specialist

    Beth Israel Lahey Health (Westwood, MA)
    …to achieve success in a value-based. Under the supervision of the Quality Manager, the Population Health Specialist (PHS) supports collaboration, communication ... leaders, practices, clinicians and hospital leadership. The Population Health Specialist is the primary point of contact with and...& Abilities:** + Strong knowledge of and experience with HEDIS ambulatory quality measures a must. +… more
    Beth Israel Lahey Health (11/07/24)
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  • Provider Account Specialist - SHP Health…

    Sharp HealthCare (San Diego, CA)
    …oversees education and communication with providers related to quality improvement and outreach initiatives, including screenings, HEDIS , health fairs, ... market issues, provider reputations, provider strengths and weaknesses, provider quality , availability, and referral source patterns, by establishing a personal… more
    Sharp HealthCare (09/14/24)
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  • Health Outcomes Pharmacist

    Highmark Health (Wilmington, DE)
    …7 years in Medicare + 5 - 7 years in Managed Care Support + 3 - 5 years in Quality Improvement + 3 - 5 years in Care Management + 3 - 5 years in Utilization ... in quality , cost, and utilization scores, identifies opportunities for improvement in value creation, cost control and utilization, performance, and develops… more
    Highmark Health (10/10/24)
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