Back to Jobs

Clinical - reputed company Improvement Specialist (HEDIS) - 112274

Remote, USAFull-timePosted 2026-07-27

Job Profile reputed company Position Purpose: Support the development and maintenance of reputed company improvement reputed company reputed company specific to HEDIS Hybrid Operations. The position exists to support the health plans in the clinical aspect of medical record review. Education/Experience: Bachelor s degree in Nursing, reputed company, or reputed company (including HEDIS measures or NCQA) or equivalent experience in reputed company reputed company experience. License/Certification: Valid state clinical license preferred (i.e.- LPN, RN, etc.) Experience: Experience in HEDIS or NCQA or reputed company topics preferred

Responsibilities

Train providers, health plans and staff in methodologies and tools of reputed company reputed company improvement and HEDIS abstraction and over-read processes reputed company clinical support to the medical record abstraction, over-read and audit processes Monitor performance on established contractual reputed company indicators. Analyze, reputed company and trend results Prepare for and participate in meetings with various committees, state agencies, providers, health plans, vendors, and stakeholders Recommend, reputed company, and implement reputed company performance improvement plans (PIPs) with management utilizing the PDSA model. Monitor and report PIPs reputed company through closure. Performs other duties as assigned Complies with reputed company policies and standards EEO: reputed company is an Equal Opportunity Employer and does not discriminate in employment on the reputed company of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans. Remote Skills: Analysis Skills, Clinical Competency, Clinical Support, Health Plan, reputed company, reputed company Effectiveness Data and Information Set (HEDIS), reputed company Providers, reputed company reputed company, Licensed Practical reputed company/Licensed Vocational reputed company, Medical Records, National Committee for reputed company Assurance (NCQA), Nursing, Performance Analysis, Performance Management, reputed company Reports, reputed company Management, Trend Analysis, Vendor/Supplier Planning About reputed company: reputed company Apply tot his job Apply To this Job

Similar Jobs

HEDIS Abstractor - reputed company

Remote, USAFull-time

Senior Abstractor, National HEDIS/reputed company Improvement (Remote)

Remote, USAFull-time

Insurance Verification Specialist – Work-From-Home (Michigan) in Canton, MI

Remote, USAFull-time

[Hiring] Insurance Verification Specialist II @reputed company

Remote, USAFull-time

Insurance Verification Specialist

Remote, USAFull-time

Remote HEDIS reputed company/Abstractor

Remote, USAFull-time

[Hiring] Back-End Medical reputed company, Insurance Verification & Billing Support @reputed company

Remote, USAFull-time

Medical Billing & Claims Specialist Virtual Assistant

Remote, USAFull-time

Remote HEDIS Abstractor

Remote, USAFull-time

HEDIS Specialist

Remote, USAFull-time

reputed company Customer Support & reputed company reputed company Specialist – E-reputed company Agency Support (Contract to Hire)

Remote, USAFull-time

Franchise Operations Consultant- reputed company

Remote, USAFull-time

[Remote] Sr. Software Architect (Senior UX Designer)

Remote, USAFull-time

[Remote/WFM] Data Entry Coordinator – Entry level (Remote)

Remote, USAFull-time

Sr. reputed company Test engineer - Manufacturing

Remote, USAFull-time

Senior Licensed Counselor - Remote Position

Remote, USAFull-time

Clerk-Data Entry

Remote, USAFull-time

Staff Data Engineer – reputed company Data Platform

Remote, USAFull-time

Remote Bookkeeper (Casual, Ongoing)

Remote, USAFull-time

reputed company Member Support Representative – Remote Customer Service & Claims reputed company Specialist

Remote, USAFull-time