- System One (Baltimore, MD)
- ALTA IT Services is hiring a 6+month contract opportunity for a HEDIS Quality Specialist to support a leading health insurance customer. The individual ... also include retrieval follow-up and escalating issues as needed. Expertise in HEDIS and Quality Measures is used to meet productivity and quality targets,… more
- TEKsystems (Baltimore, MD)
- Description: PURPOSE: The Quality Specialist - HEDIS RN/LPN with clinical experience will report to the Clinical Support Supervisor - HEDIS and be part ... also include retrieval follow-up and escalating issues as needed. Expertise in HEDIS and Quality Measures is used to meet productivity and quality targets… more
- Robert Half Office Team (Spokane Valley, WA)
- …is for a Retrieval Specialist who will be instrumental in enhancing the quality of our services through data collection and provider outreach. You will be a ... medical record requests * Perform medical record reviews for risk adjustment, HEDIS and HEDIS -like measures via remote EMR access or onsite * Schedule on-site… more
- Centers Plan for Healthy Living (Garden City, NY)
- …collect, and secure clinical documentation from Primary Care Physician (PCP) and/or Specialist (s) as indicated by HEDIS measures. + Review assigned medical ... (3) years of experience in the health care industry, in HEDIS and/or quality improvement. Experience in a managed care health services environment. Demonstrated… more
- Molina Healthcare (AZ)
- …of NCQA accreditation surveys and federal/state QI compliance activities. **A background in quality / HEDIS is very important for this position. Please have that ... experience updated on your resume.** **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Interventions / QI Compliance contributes to one or more of… more
- 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 implements new...(RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
- Centene Corporation (Austin, TX)
- …in Business, related field or equivalent experience. 3+ years of related quality improvement, HEDIS and/or NCQA experience.Pay Range: $54,000.00 - $97,100.00 ... **Position Purpose:** Develop Performance Improvement projects to improve clinical quality and performance measure outcomes. + Develop and coordinate delegation… more
- Molina Healthcare (Ypsilanti, MI)
- …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Improvement (Registered Nurse) contributes to ... or more of these quality improvements functions: Quality Interventions, Quality Improvement Compliance, HEDIS...review of records submitted by providers and the annual HEDIS medical record review. The Senior Specialist … more
- VNS Health (Manhattan, NY)
- … projects and initiatives across all product lines, including but not limited to NCQA HEDIS , NYSDOH QARR, Quality Scorecard, IPRO Projects, and CMS Quality ... OverviewConducts, coordinates and monitors quality activities and initiatives for one or more products of the Health Plan. Maintains, monitors, and develops… more
- Molina Healthcare (Flint, MI)
- …collection, reporting and monitoring for key performance measurement activities. **Experience with quality , providers and HEDIS is very important for this ... 3 years' experience in healthcare with 1 year experience in health plan quality improvement ( HEDIS ), managed care or equivalent experience. + Demonstrated solid… more
- Trinity Health (Mishawaka, IN)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **JOB SUMMARY** The Quality Improvement Specialist assists in the continuous quality ... improvement and organizational excellence of Select Health Network. The Quality Improvement Specialist will have the primary...+ Understands and stays up to date with current HEDIS measures. + Performs other duties consistent with purpose… more
- Corewell Health (Grand Rapids, MI)
- Job Summary Join the Corewell Health team as a Quality Improvement Specialist and be at the forefront of driving measurable improvements across our clinical and ... familiarity with HEDIS metrics. If you're passionate about elevating healthcare quality , closing care gaps, and making a tangible impact, we'd love to hear… more
- VNS Health (Manhattan, NY)
- …or specialist to address non-adherence and/or clinical diagnosis for HEDIS /QARR exclusion. + Participates and leads improvement teams and projects and other ... OverviewLeads interdepartmental quality improvement activities such as development and engagement,...management, and patient satisfaction. Serves as a resource to quality improvement committees and work groups. Analyzes outcome reports.… more
- InnovaCare (Ponce, PR)
- …committed to bringing passion and customer focus to the business. POSITION DESCRIPTION The Quality Specialist Nurse is responsible for monitoring quality of ... Collaborates in the implementation of educational activities geared at improving quality measures. Coordinates quality assessment activities related to clinical… more
- Elevance Health (KS)
- …reside within 50 miles of our Olathe or Topeka PulsePoint. The **Clinical Quality Program Specialist ** is responsible for supporting projects and assisting the ... quality improvement activities and programs for and/or on behalf...background. **Preferred skills, qualifications and experience:** + Experience with HEDIS strongly preferred + BS in health administration, nursing… more
- Health First (Rockledge, FL)
- *POSITION SUMMARY* The Provider Network Credentialing Specialist is responsible for coordinating, monitoring and maintaining the credentialing and re-credentialing ... credentialing policies and regulatory agencies including the National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS)… more
- HonorHealth (Scottsdale, AZ)
- … quality , performance improvement and transformation activities to achieve annual quality and operational goals. The Specialist will assist in carrying ... 3,700 affiliated providers and close to 2,000 volunteers dedicated to providing high quality care, HonorHealth strives to go beyond the expectations of a traditional… more
- Sanford Health (Worthington, MN)
- …of the assigned area(s) of nursing. Will incorporate responsibilities related to the quality risk and risk score adjustment programs. Assist with the quality ... quality risk issues and adverse events as part of the quality risk program. Will complete chart reviews, documentation of findings, referral for medical… more
- US Tech Solutions (Boston, MA)
- …for working with the care team to support the development of quality measures, code the technical specifications to operationalize the measures, and create ... pipeline and architecture to efficiently use the data for quality metrics. + Utilize statistical software and data visualization...URAC and Joint Commission. + Prior knowledge or coding HEDIS and other healthcare industry metrics used to benchmark… more
- 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:...processes or addressing gaps in processes Commitment to Quality : The IEHP Team is committed to incorporate… more