• HEDIS Reviewer II

    US Tech Solutions (May, OK)
    …to assist in any way possible to complete the screenings. * Search for relevant HEDIS records from databases, review medical records using HEDIS technical ... Participates in the member and provider outreach, collection, and review of medical records to abstract clinical information for... of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to… more
    US Tech Solutions (08/08/25)
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  • HEDIS Analyst

    Medical Mutual of Ohio (OH)
    …is a fully remote opportunity. Eastern Time Zones preferred.** **Responsibilities** ** HEDIS Analyst II ** + Coordinates and collaborates interdepartmentally to ... Maintains up-to-date knowledge and understanding of technical specifications for all HEDIS measures.Leads collaborative review of mapping documentation for… more
    Medical Mutual of Ohio (08/16/25)
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  • Health Information Management Clerk II…

    Queen's Health System (Honolulu, HI)
    …of records via secured file transfer protocol (FTP) sites for quality and payor review of records ( HEDIS /Risk Adjustment/RAC). II . TYPICAL PHYSICAL DEMANDS: ... business. * Upon request, releases records electronically for admitted patient's payor concurrent review of records. * Upon request, releases electronic copies… more
    Queen's Health System (09/09/25)
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  • Sr. Manager HEDIS

    Somatus (Mclean, VA)
    …mental well-being + Community engagement opportunities + And more! The **Sr.** ** HEDIS Manager** will be r _esponsible for providing operational/strategic support in ... planning, coordinating, and validating HEDIS , medical record reviews_ ....gaps in care. + Conduct meetings with operations to review performance and drive performance improvement outcomes based on… more
    Somatus (08/27/25)
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  • HEDIS Supervisor

    Somatus (Mclean, VA)
    …+ Support the HEDIS manager to conduct meetings with operations to review performance. + Collaborate across cross functional teams on initiatives to address care ... well-being + Community engagement opportunities + And more! The HEDIS Supervisor will be responsible for providing operational support...department to monitor use off codes such as CPT II , ICD-10, HCPCS, etc., are identified and submitted to… more
    Somatus (07/29/25)
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  • HEDIS Medical Record Retrieval Specialist…

    Excellus BlueCross BlueShield (Utica, NY)
    …you to apply! Job Description: Summary: The Medical Record Retrieval Specialist I/ II is responsible for the retrieval of medical records from various healthcare ... * Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) * Serves...retrieving medical records from providers to the plan for review and for Risk Adjustment Validation Audits (RADV). *… more
    Excellus BlueCross BlueShield (08/25/25)
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  • RN Care Coordinator II

    Covenant Health Inc. (Knoxville, TN)
    …a proud member of Covenant Health! Position Summary: The RN Care Coordinator II is responsible for integrating evidenced based clinical practice into the patient ... resource and consultant to the health care team. The RN Care Coordinator II is responsible for promoting patient care coordination and quality through the… more
    Covenant Health Inc. (07/23/25)
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  • Data Analyst II Healthcare Analytics

    Centene Corporation (Jefferson City, MO)
    …to leadership and/or customers + Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines + Support the design, ... data science, social science, or geospatial/ROI/financial analysis preferred. Experience with HEDIS , NCQA, Medicare Star Rating System, QRS, or other quality… more
    Centene Corporation (09/06/25)
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  • Clinical Data & Report Analyst

    Emory Healthcare/Emory University (Atlanta, GA)
    …complete clinical quality reporting across multiple programs including Medicare CQMs, HEDIS , Stars, and Commercial payer quality initiatives. This role is ... in appropriate clinical documentation, optimizing EMR data capture, enabling CPT II coding, and supporting the generation and submission of QRDA/CCDA reports… more
    Emory Healthcare/Emory University (09/09/25)
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  • MA Quality Performance, Pop Health Boise Clinics…

    Trinity Health (Boise, ID)
    …Quality Performance Improvement initiatives (Gaps In Care Closure) focused on Quality measures ( HEDIS ). + This position will be primarily located at one of our ... PHMA work includes supporting system-wide quality performance goals for HEDIS and STAR measures. This role reports to the...payor lists for open gaps in care, completing chart review for documentation of gap closure, and potentially some… more
    Trinity Health (09/05/25)
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