• HEDIS Analyst

    Medical Mutual of Ohio (OH)
    …reviews work of more junior-level Analyst. May supervise staff in absence of Manager + Supports HEDIS submission lifecycle processes such as data compilation, ... specification for the annual Healthcare Effectiveness Data and Information Set ( HEDIS ) lifecycle processes for all lines of business (Commercial, Marketplace,… more
    Medical Mutual of Ohio (08/16/25)
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  • Senior Medical Records Collector (Remote)

    Molina Healthcare (Akron, OH)
    …pursuit and collection of medical records and other data in collaboration with other HEDIS staff. + Assists the Manager and Supervisor(s) and/or performs the ... and reports from provider offices, loads data into the HEDIS application. + Assists the manager /lead and...into the HEDIS application. + Assists the manager /lead and quality improvement staff with physician and member… more
    Molina Healthcare (09/18/25)
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  • Specialist, Member & Community Interventions…

    Molina Healthcare (OH)
    …activities and results to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may require remediation + ... (CPHQ) + Nursing License (RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested… more
    Molina Healthcare (09/21/25)
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  • Clinical Quality Manager - Population…

    Bon Secours Mercy Health (Cincinnati, OH)
    …based contracts and gap closure work. This Population Health Clinical Quality Manager will support the Medicare Shared Savings Program (MSSP) value-based care model. ... **Primary Function/General Purpose of Position** The Manager of Population Health Clinical Quality is responsible for planning, directing, executing and managing… more
    Bon Secours Mercy Health (10/03/25)
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  • Risk & Quality Performance Manager

    Molina Healthcare (Cincinnati, OH)
    **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success. * Partner with other teams to ensure data quality… more
    Molina Healthcare (10/13/25)
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  • Manager , Medical Economics (Medicaid)…

    Molina Healthcare (Cleveland, OH)
    **JOB DESCRIPTION** **Job Summary** The Manager , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... sources. + Knowledge of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare… more
    Molina Healthcare (08/27/25)
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  • Medical Front Desk

    ChenMed (Cincinnati, OH)
    …exam rooms and ensures their comfort and well-bring prior to leaving. + Acts as HEDIS champion for the PCP by providing visibility of HEDIS needs for scheduled ... or fax. + Performs other duties as assigned and modified at manager 's discretion. **KNOWLEDGE, SKILLS AND ABILITIES:** + Exceptional customer service skills and… more
    ChenMed (10/10/25)
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  • Business Information Analyst (Population Health)

    Elevance Health (Columbus, OH)
    …and analyzes business performance reports (eg for Population Health trends, HEDIS , monitoring KPIs, claims data, provider data, utilization data) and provides ... and SQL skillset strongly preferred. + Experience working with HEDIS measures is strongly preferred. + Experience working with...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (10/09/25)
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  • Clinical Pharmacist, Population Health

    Elevance Health (Seven Hills, OH)
    …to Medicare, Commercial, and Medicaid providers, focusing on improving quality (STAR and HEDIS ) and cost measures. You will work closely with providers engaged in ... quality by staying up to date on STAR and HEDIS measures. + Provider education to support clinical pharmacy...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (10/04/25)
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  • Pharmacist, Utilization Management (UM)

    Molina Healthcare (Cleveland, OH)
    …aimed at improving STAR ratings, Healthcare Effectiveness Data Information Set ( HEDIS ), Consumer Assessment of Healthcare Providers and Services (CAHPS), and other ... care team (ICT). * Works with the Pharmacy Benefit Manager (PBM) to manage formulary changes and update marketing...3 years of experience in a pharmacy, Pharmacy Benefit Manager (PBM), formulary, and/or managed care setting, and 1-2 years… more
    Molina Healthcare (10/09/25)
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