Clinical Quality Auditor - HEDIS & Quality Score Impact
EmblemHealth
EmblemHealth is seeking a Quality Auditor to assess and audit medical records to ensure compliance with regulatory and accreditation standards. The role includes conducting targeted chart reviews and making process improvement recommendations to enhance quality scores. Qualifications include a Bachelor's Degree and a license as NP, LPN, or RN with clinical experience. The ideal candidate will have strong clinical assessment skills and attention to detail. #J-18808-Ljbffr EmblemHealth
$56.16k - $99.36k
...Job As part of the overall clinical audit process, assess and audit... ...Data and Information Set (HEDIS) and Quality Assurance Reporting Requirements... ...chart review will directly impact EmblemHealth's Quality award... ...that can negatively impact scores. May provide process...HEDISWork experience placement$56.16k - $99.36k
A healthcare company based in New York is seeking a Clinical Auditor to assess and audit medical record charts. The role involves supporting the Quality program through chart reviews and compliance assessments. Candidates should possess a Bachelor's Degree and current...HEDIS$93.4k - $116.8k
...experienced RN with a strong background in Quality including quality of care reviews,... ...? VNS Health Plans is seeking a seasoned clinical professional to play a critical role in reviewing... ...onsite medical record reviews for HEDIS or other related compliance or quality improvement...HEDISWork experience placementFlexible hours- The Ambulatory Quality and Patient Safety Specialist for Ambulatory... ...in close partnership with clinical leadership, nursing,... ...quality performance, including HEDIS, Medicaid STAR ratings, Medicare... ...Identify gaps in performance that impact quality scores, risk adjustment, and...HEDIS
$160k - $200k
...Data Scientist on the Clinical Performance team, you will... ...prove Pearl Health’s impact on the American healthcare... ...that predict our quality performance across various... ...synthetic control, propensity score matching) in real-world... ...with eCQMs, HEDIS, or claims-based quality...HEDIS- ...VP of Clinical Services – Lead, Scale, and Innovate in Healthcare Join... ...to shape clinical strategy, impact patient outcomes directly, and... ...initiatives around risk adjustment, HEDIS, STAR measures, and value-... ...risk adjustment, HEDIS, STAR quality measures, and value-based care...HEDISRemote work
- ...Overview The Transitional Care Clinical Pharmacy Manager is a core... ...Identifies and acts on high‑impact clinical opportunities early in... ...rehabilitation centers. Contributes to quality improvement initiatives aligned with CMS Star Ratings, HEDIS measures, and value‑based care...HEDISRemote work
$152k - $190k
Clinical Pharmacy ManagerSkip to main content#Clinical Pharmacy Manager... ...Identifies and acts on high-impact clinical opportunities early in... ...centers* ## Contributes to quality improvement initiatives aligned with CMS Star Ratings, HEDIS measures, and value-based care...HEDISRemote workShift work- ...fresh solutions, and meaningful impact. The workforce is made up of... ...will define program strategy, clinical workflows, staffing model, technology... ...across Clinical, Product, IT, Quality/Accreditation, Analytics,... ...in regulated environments (NCQA, URAC, CMS/Stars, HEDIS)...HEDISContract work
$56.2k - $75.29k
...Coordinates the delivery of high quality, cost-effective care based on... ...services model supported by clinical practice guidelines established... ...Data and Information Sheet (HEDIS). Skills and Abilities Requires... ...are passionate about making an impact, we’d love to hear from you!...HEDISLive inWork at officeLocal area$140k - $180k
Director of Clinical Operations The Director of Clinical Operations is... ...(UM), Care Management (CM), Quality, and clinical program implementation... ..., member outcomes, CAHPS, HEDIS, and Star Ratings where... ...ambiguity, and make timely, high-impact decisions. Strong experience...HEDISFull time$195.3k - $227.85k
...Associate Director, Clinical Quality Assurance Auditor page is loaded## Associate Director, Clinical Quality Assurance Auditorlocations: Remotetime... ...opportunity to help enhance quality culture while having a direct impact on our late and early-stage clinical trials that are the...Contract workLocal areaRemote work- ...Join to apply for the Clinical Transformation Consultant role at Innovaccer... ...Day in the Life Deliver high‑impact, clinically accurate, and... ...requirements—care management, quality improvement, chronic disease management... ...requirements (e.g., HEDIS, CMS, value‑based care models)...HEDISTemporary workLocal areaImmediate startRemote work
$93.4k - $116.8k
...experienced RN with a strong background in Quality including quality of care reviews,... ...? VNS Health Plans is seeking a seasoned clinical professional to play a critical role in reviewing... ...onsite medical record reviews for HEDIS or other related compliance or quality improvement...HEDISWork experience placementFlexible hours$42.26 - $45.78 per hour
...Clinical Pharmacist We are looking for a Clinical Pharmacist to join... ...resource responsible for quality measures supporting the pharmacy... ...department in identifying Star/HEDIS measure needs and expectations... ...monitor the quality, care, and cost impact of the Star/HEDIS program and...HEDISHourly pay- ...divh2Quality Assurance Clinical-Billing Auditor-QA535206/h2pJob Category: Human/Social Services Requisition Number: QUALI008027/ppFull-Time Salary: $76,000 USD per year/ppDepartment of Quality 125 Broad St New York, NY 10004, USA/ph3Description/h3pstrongJob Summary/strong...
$94k - $115k
...us. Summary of Position The Clinical Services Supervisor, in collaboration... .... This role ensures the delivery of high-quality, patient-centered care and carries administrative... ...patient care and outcomes. Ensure all HEDIS (Healthcare Effectiveness Data and...HEDISWork experience placementWork at officeLocal area$39.96k - $70.2k
...and validate data entry to support continuous quality improvement in Healthcare Effectiveness Data and Information Set (HEDIS) rates and STAR measures for the enterprise.... ...measures to ensure member receipt of important clinical services to improve member health outcomes....HEDIS$55 per hour
...Healthcare Partners is seeking a local contract nurse RN Clinic Oncology for a local contract nursing job in New... ...Practical Nurses (LPN) ● Travel Nursing ● Quality Assurance/Review, Performance Improvement, HEDIS ● Nursing Leadership ● Case Management ALLIED...HEDISHourly payWeekly payContract workLocal areaShift work- ...Health provides the highest quality healthcare services to... ...specialists and participating clinics. For more than 40 years,... ...Quality Management on HEDIS, STAR ratings and CAHPS score improvement initiatives and... ...that will illustrate the impact on members' utilization....HEDISWork at officeShift work
$1,000 per month
...opportunities And more! The Vice President of Clinical Performance, under direction of the Chief... ...-wide efforts to improve value (clinical quality, patient safety, patient experience,... ...outcome management, patient safety, NCQA HEDIS quality performance, etc. Analyze, interpret...HEDISWork at officeLocal areaFlexible hours- ...looking for a Data Engineer with experience in clinical data who designs and builds scalable data... ...to normalize clinical data supporting quality reporting, risk adjustment, and... ...compliance, and analytics teams Support CMS, HEDIS, and risk adjustment reporting Optimize...HEDISFull timeTemporary workImmediate startRemote work
$85k - $106.3k
Overview Leads interdepartmental Quality Improvement (QI) initiatives focused on promoting... ..., and equitable member care. Serves as a clinical and operational resource to QI committees... ...workgroups, and leadership. Analyzes outcomes, HEDIS/CAHPS/Stars performance, and trend data...HEDISWork experience placementFlexible hours$75k - $98k
Clinical Quality Assurance Specialist US - Remote Who Are We And Why Should You Join Us? BetterHelp is on a mission to remove the traditional... ...At BetterHelp, you'll carve your own path, make an immediate impact, and be challenged every day - with a supportive community...Full timeWork experience placementWork at officeImmediate startRemote work$90k - $140k
...This individual will report to the Associate Director of Clinical Programs Business Development and be responsible for... ...Preferred Qualifications PharmD Experience working with HEDIS, Stars and PQA pharmacy quality measures Proficient in Microsoft Office Suite with...HEDISBase plus commissionWork at officeLocal areaRemote work$79.31k - $158.62k
...ourselves accountable and prioritize safety and quality in everything we do. Join us and be part... .... A&BC leverages advanced analytics, clinical informatics, and hypothesis-driven... ..., value-based care, quality measurement (HEDIS, Stars), and population health. Education...HEDISHourly payFull timeTemporary workLocal areaShift work$114k - $143k
RN Clinical Care Manager/Case Manager - New York Position Summary: The RN Clinical Care Manager... ...Health Management interventions and HEDIS/STAR measures for identified areas of provider... ...services, clinical operations, quality, or care management 3 years of experience...HEDISTemporary workWork at officeLocal area$58 - $60 per hour
...Midtown Manhattan. The candidate will drive quality improvement initiatives and lead a team... ...improvement and management, and strong clinical judgment. The role offers flexible hours... ...$60/hr, with a focus on making a tangible impact on quality care. #J-18808-Ljbffr PhaxisHEDISLocal areaFlexible hours- ...Overview The Contact Center Quality Analyst (CCQA) is responsible... ...evaluation criteria and quality scoring methodologies consistently... ...contact center Familiarity with HEDIS, Star Ratings, or URAC/NCQA... ...environment connecting QA, compliance, clinical, and operations teams An...HEDIS
$58 - $60 per hour
...Wellness QA Nurse Manager (RN) to lead quality improvement initiatives, support... ...excellent opportunity for a strong clinical leader who understands HEDIS, quality metrics, population health,... ...organization where your leadership directly impacts quality outcomes and patient care....HEDISWeekly payFull timeContract workImmediate start
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Clinical Quality Auditor - HEDIS & Quality Score Impact. Be the first to apply!
- quality system auditor New York, NY
- quality management specialist New York, NY
- quality systems specialist New York, NY
- quality specialist New York, NY
- warehouse quality control associate New York, NY
- quality associate New York, NY
- quality auditor New York, NY
- quality control associate New York, NY
- quality review specialist New York, NY
- quality improvement specialist New York, NY

