• Manager HEDIS Program

    Martin's Point Health Care (Portland, ME)
    …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Manager , HEDIS Program educates and serves as the HEDIS subject ... matter expert (SME). The Manager , HEDIS Program is responsible for coordinating, implementing, and executing HEDIS Program specific projects, and… more
    Martin's Point Health Care (08/29/25)
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  • HEDIS Analyst

    Medical Mutual of Ohio (OH)
    …by members, and members' health outcomes.** **Note: This is a fully remote opportunity. Eastern Time Zones preferred.** **Responsibilities** ** HEDIS Analyst II** ... more junior-level Analyst. May supervise staff in absence of Manager + Supports HEDIS submission lifecycle processes...keyboard, mouse and headset. + Whether you are working remote or in the office, employees have access to… more
    Medical Mutual of Ohio (08/16/25)
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  • HEDIS Program Manager II

    Centene Corporation (Harrisburg, PA)
    …of PA Health & Wellness, a subsidiary of Centene Corporation and will oversee program initiatives for the Medicaid product line of business encompassing HEDIS , ... strategic objectives. Collaborate with internal and external stakeholders to ensure HEDIS and CAHPS initiatives are fully integrated throughout the organization,… more
    Centene Corporation (09/06/25)
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  • Risk & Quality Performance Manager

    Molina Healthcare (Albany, NY)
    **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 (07/31/25)
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  • Manager Integrated Case Mgmt-SCMG…

    Sharp HealthCare (San Diego, CA)
    …Healthcare Quality (CPHQ) - National Association for Healthcare Quality; Certified Case Manager (CCM) - Commission for Case Manager Certification **Hours** **:** ... for the development and implementation of an effective Hospital Case Management program (HCM) and Ambulatory Case Management (ACM) program that encompasses… more
    Sharp HealthCare (08/29/25)
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  • RN Care Manager Complex Adult Care…

    Molina Healthcare (Buffalo, NY)
    …This position will be supporting our Complex Adult Medical Care Management program . The ideal candidate will bring strong expertise in chronic disease management, ... asthma, COPD, and chronic kidney disease/ESRD. Skilled in closing HEDIS and preventive care gaps through proactive outreach and...beneficial. Case management and managed care experience is preferred. Remote position based in New York A New York… more
    Molina Healthcare (08/29/25)
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  • Medical Director - Sharp Health Plan - Hybrid…

    Sharp HealthCare (San Diego, CA)
    …for implementing the Utilization/Cost Management Program and Quality Improvement Program , in conjunction with the Manager Medical Management and Quality ... care needs of the membership. Serves as a medical manager and policy advisor to SHP and its Chief...plan Chief Medical Officer) in short and long range program planning, total quality management (quality improvement), and external… more
    Sharp HealthCare (08/17/25)
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  • Quality Program Development Manager

    Centene Corporation (Jefferson City, MO)
    …goals of clinical and administrative operations. The Quality Program Development Manager position is primarily remote . Candidates based in Missouri, Iowa, or ... a fresh perspective on workplace flexibility. **Position Purpose:** Functions as a program development manager in collaboration with Quality, Health Services and… more
    Centene Corporation (08/27/25)
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  • Senior Medical Director - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …of care foundation for our NCQA required population health management program . Additionally, this position provides the representation of physician's insight, ... needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'...+ Plans, organizes, and directs the professional medical services program , consisting of all primary and specialty services for… more
    Sharp HealthCare (07/19/25)
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  • Senior Specialist, Member & Community…

    Molina Healthcare (UT)
    …quality focused interventions and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including key ... + Acts as a lead specialist to provide project, program , and/or initiative related direction and guidance for other...to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may… more
    Molina Healthcare (07/31/25)
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