Remote HEDIS Nurse Reviewer & Quality Educator
Elevance Health
- Remote job
Elevance Health is seeking a HEDIS Medical Record Review Project Nurse to support HEDIS data collection and quality review. This is a virtual, full-time role with required in-person training sessions; candidates must reside in Florida and be able to travel for training if needed. The position emphasizes accuracy, process adherence, and provider education. The ideal candidate has a nursing degree, an active state license, and at least two years of clinical or HEDIS chart review experience. #J-18808-Ljbffr Elevance Health
- ...clinically experienced and detail-oriented Nurse Educator & Quality Assurance Specialist (Contractor) to... ..., you will conduct clinical quality reviews of telehealth consults and... ...protocols and external standards (e.g., CMS, HEDIS, HIPAA)/ Identify patterns in documentation...Remote workHEDISQualityContract workFor contractors
- ...To support the improvement of kidney care, the remote Quality Improvement Specialist will manage patient and provider... ...performance insights, and drive improvements in HEDIS and Medicare Stars measures through targeted education and collaboration. Key responsibilities Engage...Remote workHEDISQuality
- ...Collaborating with the Manager, the full-time remote Sr. Associate, Quality Operations will drive quality performance in alignment with organizational... ...teams. Key responsibilities Serve as Quality SME for HEDIS/Stars specifications and lead quality meetings with payor...Remote workHEDISQualityFull time
- ...Quality Improvement Specialist Are you a detail-oriented healthcare professional looking for a work-from-home role supporting HEDIS operations? We are seeking a dedicated Quality Improvement Specialist... ...MY26 HEDIS season! In this key remote role, you will work within...Remote workHEDISQualityMonday to Friday
- ...Remote role but will need to go to Newark, NJ... ...responsible for conducting quality audits for state audits, HEDIS and quality referral... ...1. Conducts on-site reviews at participating... ..., providing education and discussing opportunities... ...License Practical Nurse License or an active...Remote workHEDISQuality
$51k - $82k
..., investigation, and medical review to detect, prevent, deter, reduce... ...We are looking to add a Nurse Reviewer to our SGS team of... ...referral to law enforcement, education, over payment recovery. Will... ...member of a team to deliver high quality work Ability to attend...Remote workQualityContract workShift workNight shift- ...Certified Coding Specialist III, this fully remote position requires expertise in coding... ...ICD-10 CM, PCS, CPT, HCPCS, HCC, and HEDIS CAT II codes, while also providing guidance... ...a minimum accuracy rate of 95% on quality reviews while meeting productivity standards Coach...Remote workHEDISQuality
- ...Texas for an upcoming remote project focused on improving Medicare quality outcomes and closing care... ...conduct telephonic medication reviews and outreach to Medicare... ...for drug interactions, educate patients on chronic... ...with Medicare STARs and HEDIS measures Bilingual candidates...Remote workHEDISQualityMonday to Friday
- ...Nurse Reviewer Contract Duration: Initial 6-months Pay: $27.50/hr on W2 Start Date: 9/8/2026 Location: Fully Remote (US Only) LPN State License must be active and in good standing... ...is contingent upon meeting quality standards. Once training is...Remote workQualityContract work
- ...Provide timely review and determination of medical claims, including... ...Maintain a 97% or higher quality score work experience requirements... ...State license as a Registered Nurse (RN),as required by contract(s... ...for this position Remote but need to be local to 18702...Remote workQualityContract workFor contractorsWork experience placementWork at officeLocal area
$115k - $150k
...Engineer / Senior Data Engineer - Healthcare DataLocation: 100% Remote - United States (CST/EST Hours)Salary Range: $115-150K +... ...data technologies to improve how critical claims, enrollment and quality information is processed, transformed and utilized throughout the...Remote workHEDISQuality$78k - $99.2k
...Senior Nurse Reviewer Make a meaningful impact on healthcare quality and claims accuracy by applying your clinical expertise... ..., training, and feedback. This remote opportunity combines clinical analysis... ..., mentoring, feedback, and education. Maintain current knowledge...Remote workQualityFull timeWork from homeFlexible hours$135k
...Nurse Practitioner Delaware | Remote | Full-Time This is a remote position. Join our client's innovative... ...care planning discussions Support quality initiatives through accurate clinical... ...adjustment, and closure of STAR and HEDIS quality gaps Help develop and refine...Remote workHEDISQualityFull time- ...HEDIS Auditor RN/LPN Integrated Resources, Inc is... ...delivering only the best quality talent, the first time... ...Therapy and Nursing. Job Description: This... ...performing medical record reviews and data extraction for... ...which candidate must attend and remote other days....Remote workHEDISQualityContract workWork from home
- ...counseling and diabetes self-management education/training to individuals and groups.... ...progress. # Coordinates with physicians, nurses, and other care team members to... ...diabetes educators. # Participates in HEDIS and other quality improvement efforts to enhance patient...HEDISQualityWork at office
- ...Job Description The Quality Improvement Manager is... ...with a primary focus on HEDIS measures, payer incentive... .... Location: Remote opportunity for Oregon,... ...quality performance. Education & Staff Engagement Develop... ...administration, nursing, public health, health...Remote workHEDISQualityWork at office
- ...counseling and diabetes self-management education/training to individuals and groups.... ...progress. Coordinates with physicians, nurses, and other care team members to support... ...diabetes educators. Participates in HEDIS and other quality improvement efforts to enhance patient...HEDISQualityFull time
- ...Duration: Long Term Location: Remote Certifications: Epic Caboodle Certification... ...My Panel Metrics (MPMs), Healthy Planet, HEDIS, care gap reporting, SlicerDicer, Radar... ...MPMs are provider-facing operational and quality metrics used heavily within population...Remote workHEDISQuality
- UnitedHealth Group seeks a Director of Product on the Quality Optimization team within OptumInsight to drive strategy and execution for NCQA, CMS Stars, MSSP, and related quality programs. Remote work is possible nationwide with in-office requirements in Minneapolis or...Remote workHEDISQualityWork at office
$42.26 - $45.78 per hour
..., dedicated clinical resource responsible for quality measures supporting the pharmacy department in identifying Star/HEDIS measure needs and expectations, and developing... ...recommended clinical solutions Develop, review and monitor clinical programs, therapeutic initiatives...Remote workHEDISQualityHourly pay- ...seeking a senior leader to drive the digital quality measurement strategy and modernize how... ..., and reported. You will lead NCQA/HEDIS initiatives, oversee STARS improvements,... ...technology solutions while supporting a remote work setup across the United States. #J-...Remote jobHEDISQuality
- ***Remote and must live in the Eastern or Central Time... ...program(s) supporting quality, cost-effectiveness, and... ...submitted for review. • Provides oversight... ...management and health education programs including, but... ...Data Information Set (HEDIS), and disease management...Remote workHEDISQualityLive inWork at office
- ...Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6+ Months Contract... ...LPN with experience supporting HEDIS reporting and abstraction processes... ...will understand NCQA healthcare quality metrics and have a proven...Remote workHEDISQualityContract workWork at office
- ...but not limited to collecting, analyzing, validating reports for HEDIS. Working in a team environment this position will assist the... ...Regulators, and will be required to maintain the highest level of quality. The ideal candidate will have a desire to complete all of their...Remote workHEDISQuality
$78k - $85k
...Outpatient Quality Improvement Consultant Our client is seeking... ...organization offers a collaborative, remote-first culture focused on... ...Qualifications: • Bachelor's degree in nursing, public health, healthcare... ...• Experience with HEDIS, preventive care metrics, chronic...Remote workHEDISQualityMonday to FridayFlexible hours- ...Hourly Location : Remote with 75% travel Reports... ..., and Clinical Educators. Success as the... ...organizational success in quality, operational,... ...Practical Nurse 3-5 years of clinical... ...Medical Home, and Hedis Measures. Assist with... ...report evaluation. Reviews patient medical...Remote workHEDISQualityHourly payFull timeWork at office
- UnitedHealth Group seeks a Director of Product, Quality Optimization to drive strategy and execution across Hedis/Stars quality programs, with a focus on AI-enabled improvements and revenue growth. Remote work available across the U.S.; Minneapolis/DC office requirements...Remote jobHEDISQualityWork at office
- A healthcare organization is seeking a Nurse Reviewer to perform comprehensive medical necessity... ...position offers a chance to work in a remote setup with competitive hours. Benefits include... ..., dental, and 401k options. #J-18808-Ljbffr Healthcare Quality Strategies, Inc. (HQSI)Remote jobQuality
- ...Group's Optum Insight is seeking a Director of Product on the Quality Optimization team to drive strategy and execution across NCQA Health... ...and oversee the product lifecycle from concept to delivery. Remote work from anywhere in the U.S. is allowed, with in-office four...Remote jobHEDISQualityWork at office
- Gainwell Technologies LLC is seeking a Senior Nurse Reviewer to perform reviews of medical records, healthcare claims, itemized medical bills... ...position within the continental US, supporting a flexible, quality-driven team environment. #J-18808-Ljbffr Gainwell...Remote jobQualityWork from homeFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote HEDIS Nurse Reviewer & Quality Educator. Be the first to apply!
- remote recruitment consultant Tallahassee, FL
- remote data manager Tallahassee, FL
- benefits specialist remote Tallahassee, FL
- remote video game Tallahassee, FL
- remote typing work Tallahassee, FL
- remote fashion Tallahassee, FL
- remote autocad jobs Tallahassee, FL
- remote operation drilling engineer Tallahassee, FL
- remote french Tallahassee, FL
- customer service rep remote Tallahassee, FL




