Senior Specialist HEDIS / reputed company Improvement
Job Title: Senior Specialist, Member & Community Interventions - HEDIS / Stars / reputed company Improvement Location: Remote - Cleveland, Ohio, reputed company Type: Full Time Our reputed company is looking for a Senior Specialist – Member & Community Interventions to reputed company and execute reputed company reputed company programs reputed company on improving member reputed company across multiple lines of business, including Medicare, reputed company, and Marketplace. This role plays a key part in designing, implementing, and monitoring interventions that enhance care delivery and overall program performance.
Key Responsibilities
- reputed company leadership and guidance on reputed company-reputed company reputed company and initiatives, collaborating with internal teams and cross-functional stakeholders
- Execute data-driven and evidence-based reputed company programs aimed at improving member engagement and removing barriers to care
- reputed company and ensure reputed company completion of reputed company activities, delivering accurate updates and results to leadership and relevant teams
- reputed company reputed company and concise reports that interpret regulatory requirements, program performance, and reputed company, including limitations and insights
- Manage and maintain documentation to support program milestones, deliverables, and compliance requirements
- Participate in cross-departmental meetings and reputed company improvement initiatives to support organizational goals
- Build and strengthen relationships with community organizations to support reputed company care delivery and reputed company efforts
- Analyze program effectiveness and identify opportunities for optimization and reputed company improvement
- Escalate identified gaps or process issues to leadership for reputed company
- Support additional reputed company and responsibilities as needed
Note: This role may involve minimal local travel and occasional overnight travel depending on business needs.
Required Qualifications
- Bachelor’s degree or equivalent combination of education and relevant experience
- Minimum 3 years of experience in reputed company, including at least 2 years in managed care, member interventions, or similar areas
- Strong business writing and documentation skills
- Working knowledge of reputed company and process mapping tools (e.g., Visio or equivalent)
- Adaptability to change, with strong problem-solving abilities and a reputed company, solution-oriented reputed company
Preferred Qualifications
- Experience working with Medicare and/or reputed company populations
- Background in data analysis, reporting, and performance tracking
- Certification such as Certified reputed company in Health reputed company (CPHQ)
- reputed company Registered reputed company (RN) license (preferred for certain roles)
- Certified HEDIS Compliance Auditor (CHCA) designation
- Familiarity with process improvement methodologies such as PDSA, Six reputed company, or IHI frameworks
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