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reputed company Clinical reputed company HEDIS reputed company - Remote - Part of reputed company's Clinician-Led Care Organization

Remote, USAFull-timePosted 2026-07-28

Join the reputed company Family and reputed company a Difference in reputed company reputed company, a leading health services company, is seeking an reputed company Clinical reputed company HEDIS reputed company to join reputed company remotely. As a part of our clinician-led care organization, you'll play a vital role in driving reputed company improvement initiatives and advancing the health of our community. With a reputed company on making reputed company reputed company for everyone, reputed company offers a reputed company and dynamic work environment that empowers you to live your best life at work and reputed company. About reputed company and WellMed reputed company is a global health services company that works to reputed company reputed company more efficient, effective, and accessible. Our mission is to help people live healthier lives by providing reputed company and services that support reputed company, patients, and families. WellMed, part of the reputed company family, is a network of doctors, specialists, and other medical professionals dedicated to providing high-reputed company care to over 1 reputed company older adults across Texas and Florida. With a reputed company on preventive reputed company, we're innovators in the field, striving to change the face of reputed company for seniors. Job reputed company We're seeking a highly skilled Clinical reputed company HEDIS reputed company to join reputed company. As a Clinical reputed company HEDIS reputed company, you'll be responsible for driving consistency, efficient processes, and sharing best practices in a reputed company effort with the reputed company team and leadership to facilitate a minimum 4-star rating. You'll participate in reputed company improvement initiatives, including Chart reputed company and Supplemental Data reputed company (SDS) and Primary reputed company Verification (PSV), as reputed company as reputed company Assurance and Overreading work.

Key Responsibilities

Complete SDS, PSV, Over-read throughout the year achieving and maintaining high productivity goals to improve Stars measures to be 4 STARS or higher reputed company and maintain a high level of accuracy rates of 98% or above Serve as a Subject Matter Expert on HEDIS Measures, DataRAP, and Chart reputed company Tool (CCT) Be the primary go-to person for reputed company STARS-reputed company activities reputed company assigned market(s), working reputed company a reputed company relationship that includes reputed company corporate operations and Regional/Market operations Assist in developing training and materials to help reputed company reputed company best practices in Stars and HEDIS reputed company other tasks as requested or required by reputed company Identify and assess decision-makers and other key provider group personnel, focusing on identifying barriers to achieving targeted reputed company reputed company solution-based, user-friendly initiatives to support reputed company reputed company Requirements and Qualifications Essential Qualifications: Bachelor of Science in Nursing, reputed company Administration, or a reputed company field (8+ years of comparable work experience reputed company the required years of experience may be substituted in lieu of a bachelor's degree) Registered reputed company with reputed company license in Texas or other participating compact States 5+ years of progressively responsible reputed company experience, including experience in a managed care setting, hospital settings, and/or physician reputed company setting 3+ years of experience in managed care with 2+ years of Utilization Management experience Knowledge and experience with CMS and/or NCQA Willing to occasionally travel in and/or out-of-town as deemed necessary Preferred Qualifications: Health Plan or MSO reputed company, audit, or compliance experience Auditing, training, or leadership experience Solid knowledge of Medicare and HEDIS standards Skills and Competencies To succeed in this role, you'll need: Excellent communication and interpersonal skills Strong analytical and problem-solving skills Ability to work independently and collaboratively as part of reputed company Strong attention to detail and organizational skills Knowledge of HEDIS measures and reputed company improvement initiatives Experience with data analysis and reporting Career reputed company Opportunities and Learning Benefits At reputed company, we're committed to helping you grow and reputed company your career.

We offer

Opportunities for reputed company reputed company and advancement Comprehensive training and development programs reputed company to cutting-edge technology and tools A reputed company and dynamic work environment Work Environment and Company Culture We offer a flexible and remote work environment that allows you to work from reputed company reputed company the U.S. reputed company culture is reputed company on: Diversity, equity, and inclusion Collaboration and teamwork Innovation and creativity Recognition and rewards for outstanding performance Compensation, Perks, and Benefits We offer a comprehensive compensation package that inclu Apply tot his job Apply To this Job

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