• HEDIS Data Reviewer

    US Tech Solutions (Philadelphia, PA)
    …weekend work may be required)** **Job Description:** + Under the direction of the Manager of Medical Record Review Operations, the HEDIS Data Reviewer is ... in support of Quality reporting (annual Healthcare Effectiveness Data and Information Set ( HEDIS ) and State EQRO) with duties including but not limited to the… more
    US Tech Solutions (01/14/26)
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  • Business Information Analyst II - HEDIS

    Elevance Health (Seven Fields, PA)
    **Business Information Analyst II - HEDIS Quality Analytics** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering ... and formats and utilizing multiple data systems to analyze HEDIS results is preferred. + Experience with relational databases...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (01/01/26)
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  • Senior Specialist, Member & Community…

    Molina Healthcare (OH)
    …within the department and/or collaboratively with other departments. Please include any HEDIS /Quality experience on your resume. This experience is important for the ... to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may...(RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
    Molina Healthcare (10/19/25)
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  • Medical Claims Research Specialist

    US Tech Solutions (Canton, MA)
    …**2026** **Overview** + Under the general direction of the Quality Program Manager (s), the Medical Claims Research Specialist(s) will review medical claims reports ... record(s) and/or provider(s), and document follow-up actions during the HEDIS (Healthcare Effectiveness Data Information Set) reporting period. **Principal Duties… more
    US Tech Solutions (12/30/25)
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  • Senior Medical Management Nurse - VCHCP

    Ventura County (Ventura, CA)
    …members to resolve service issues, ensure regulatory compliance (DMHC, NCQA, HEDIS ), and support wellness, prevention, and disease management programs. This position ... preventing diseases, and maintaining well-being; + Assumes responsibilities related to HEDIS , including data collection, reporting, and ensuring compliance with … more
    Ventura County (12/07/25)
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  • RN Manager Care Quality

    HCA Healthcare (Salt Lake City, UT)
    …integrity. We care like family! Jump-start your career as a(an) Manager Care Quality today with MountainStar Healthcare. **Benefits** MountainStar Healthcare, offers ... vary by location._** Come join our team as a(an) Manager Care Quality. We care for our community! Just...Home (PCMH), government programs (CMS), accountable care organizations (ACOs), HEDIS , and experience with payor cost sharing initiatives +… more
    HCA Healthcare (12/30/25)
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  • Substance Abuse / SUD Care Manager - LCSW,…

    Fallon Health (Worcester, MA)
    …on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The SUD Care Manager is responsible for ensuring seamless coordination of care for Fallon Health ... other partners-to promote integrated, member-centered care. The SUS Care Manager drives effective discharge planning, facilitates timely communication across care… more
    Fallon Health (12/30/25)
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  • Quality Improvement Professional

    CenterWell (Houston, TX)
    …improvement best practice initiatives designed to improve Medicare quality measures ( HEDIS ), patient safety and patient experience (CAHPS-HOS). QIP assignment may be ... experience working with clinical quality measures in particular medication adherence and HEDIS . + Utilize approved avenues to outreach to patients with medication… more
    CenterWell (12/19/25)
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  • Sr. Manager Medicare Stars Program

    CVS Health (St. Louis Park, MN)
    …it all with heart, each and every day. **Position Summary** As the **Senior Manager of Stars** , you will lead the market-wide strategy, performance improvement, and ... outcomes and program performance. + Collaborate with internal teams ( HEDIS , Clinical Operations, Network, Pharmacy, Product, Member Experience, Data/Analytics,… more
    CVS Health (12/31/25)
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  • Integrated Health Advancement Program…

    Blue KC (MO)
    …discount program** **Job Description Summary:** The Integrated Health Advancement Program Manager leads an integrated behavioral health and health outcome strategy ... + Direct health outcome initiatives addressing systemic barriers to care, disparities in HEDIS and STAR measures, and drivers of social and behavioral health. +… more
    Blue KC (12/04/25)
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