Senior Quality Improvement Lead - HEDIS (Medicaid, Remote)
Humana
- Remote job
Humana Inc. seeks a Senior Quality Improvement Professional to lead Kentucky Medicaid quality performance initiatives and strengthen the Humana Healthy Horizons program. You will manage cross-functional QI projects, develop measurable improvement plans, and ensure documentation compliance (QI Program Descriptions, Work Plans, Evaluations). Remote with periodic travel to Kentucky; strong data analytics required. #J-18808-Ljbffr Humana
- UnitedHealth Group seeks a Sr. Clinical Quality Consultant RN to drive STARS and quality improvement across the Inner West Valley... .... This hybrid role combines remote work with in-person meetings and... ...higher quality metrics. You will lead data analysis, develop...Remote workHEDISQualitySenior
- ...Senior Quality Improvement Specialist (RN) Location: NYCLAY (100% remote) Duration: 45 W, 3 D Client: Molina Healthcare 100% remote... ...Quality Improvement Compliance, HEDIS, and / or Quality Reporting.... ...QI Compliance Acts as a lead specialist to provide project-...Remote workHEDISQualitySenior
$72.8k - $130k
...team will directly improve health outcomes by... ...together.For you, quality counts. For... ...our industry. As a Senior Clinical Quality Auditor... ...to work remotely * from anywhere within... ...measures such as HEDIS Experience developing... ...incidents Knowledge of Medicaid rules and...Remote workHEDISQualitySeniorMinimum wageFull timeWork experience placementLocal area$229.2k - $265.39k
...The Sr. Director leads complex contract negotiations... ....Commitment to Quality: The IEHP Team is... ...not limited to, HEDIS, CAHPS, and NCQA... ...enhancements that improve efficiency and... ...methodologies related to Medicaid, Medicare and... ...schedule. (Mon & Fri - remote, Tues - Thurs...Remote workHEDISQualitySeniorOngoing contractContract workTemporary work$220.04k - $302.54k
...Financial Officer, the Senior Director of... ...-effective, high-quality care improve margin, affordability... ...not limited to, HEDIS, CAHPS, and NCQA... ...Initiatives: Lead identification, evaluation... ...:Experience in Medicaid managed care or... ...& Friday - remote, Tuesday - Thursday...Remote workHEDISQualitySeniorTemporary workMonday to FridayShift work$112.7k - $193.2k
...Individual (E&I) HEDIS Retrospective Operations... ..., this role leads a team of data engineers... ...to work remotely * from anywhere within... ...functional logic, quality measures, issue resolution... ...across Medicare, Medicaid, and Commercial... ...disparities and improves health outcomes -...Remote workHEDISQualitySeniorMinimum wageFull timeWork experience placementWork at officeLocal area$91.7k - $163.7k
...team is seeking a Senior Data Engineer to support... ...Individual (E&I) HEDIS Retrospective data... ...enable healthcare quality reporting,... ...across Medicare, Medicaid, and Commercial lines... ...flexibility to work remotely * from anywhere... ...engineering workflows, improve operational...Remote workHEDISQualitySeniorMinimum wageFull timeWork experience placementWork at officeLocal area$110k - $160k
...(Medicare and Medicaid), drastically changing their quality of life and health... ...leader in improving health outcomes... ...accounts with leading health plans and... ...presentations (remote and in-person)... ...stakeholders, both senior and junior, representing... ...supporting HEDIS performance...Remote workHEDISQualitySeniorFlexible hours$51.9k - $74.2k
...Quality Improvement Specialist Great companies need great teams to propel... ...improvement, preferably supporting Medicaid programs. Bachelor's degree... ...quality measures, HEDIS, quality withholds, and population... ...to work effectively in a remote environment Adaptability and...Remote workHEDISQualityWork at office$115.2k - $158.4k
...caring communityThe Senior Portfolio Enablement Lead is a strategic portfolio... ...design, and improving alignment, flow, and... ...attention to detail and quality of work productAbility... ...Geography Remote - This is a remote position... ...people with Medicare and Medicaid, families,...Remote workQualitySeniorBi-weekly payFull timeTemporary workWork at officeWork from homeHome office$34 - $51 per hour
...leader in providing advocacy, quality healthcare and social... ...counties since 1970. Senior Quality Improvement Specialist Location: West... ...In this role, you will lead complex, cross-functional... ...with HRSA UDS, HEDIS, Medicare, and Medicaid quality measures and performance...HEDISQualitySeniorFull timeTemporary workMonday to Friday$72.37k - $156.8k
...DESCRIPTION Job Summary Provides lead level analyst support... ...of business. Develops quality assurance (QA) ad-hoc... ...to risk adjustment for Medicaid, Marketplace and... ...health care quality and HEDIS rate tracking, medical... ...starter with a continuous improvement mindset. Effective...Remote jobHEDISQualityWork experience placementWork at office$90k - $100k
...healthcare affordable, improve the health of... ...leverages remotely-embedded... ...to deliver high-quality healthcare focused... ...Description As Senior Data Analyst,... ...visualizations that lead with the... ...and reporting (HEDIS, eCQMs, MIPS, Stars, state Medicaid measure sets)....Remote workHEDISQualitySeniorBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from homeFlexible hoursShift work$78.8k - $177.68k
...Company Overview: Leading with our core values of Quality, Integrity, and... ...client-focused Senior Enterprise... ...Medicare Advantage, Medicaid, commercial... ...frameworks, such as HEDIS, population... ...organization focused on improving healthcare... ...can be located remotely within the US....Remote workHEDISQualitySeniorFull timeWork experience placementFlexible hours$115k - $150k
...through: 2027-08-20Title: Data Engineer / Senior Data Engineer - Healthcare DataLocation: 100% Remote - United States (CST/EST Hours)Salary... ...and modern data technologies to improve how critical claims, enrollment and quality information is processed, transformed and...Remote workHEDISQualitySenior- JOB DESCRIPTION Job Summary Leads and directs team responsible for Medicare Stars quality improvement (QI) programs and activities. Oversees... ...Data and Information Set (HEDIS), pharmacy, operations,... ...government-sponsored programs (Medicaid, Medicare, Marketplace). Experience...Remote jobHEDISQualityContract workWork at office
$59.81k - $129.59k
...DESCRIPTION Provides senior-level analytical support... ...decision-making, and improve cost of care outcomes.... ...Essential Job Duties Leads medical cost, utilization... ...knowledge of Medicaid, Medicare, Marketplace... ..., disease management, HEDIS quality measures, claims processing...Remote jobHEDISQualitySeniorWork experience placementWork at office$54.92k - $107.1k
...Job Summary Provides senior level support for implementation... ...to drive necessary quality and risk adjustment... ...and quality improvement activities. Ensures assigned... ...collaboration to improve Medicaid, Medicare and... ...improving population-level HEDIS quality scores and burden...Remote workHEDISQualitySeniorFull timeWork at office$127k - $160k
...innovation. Job Summary The Senior Manager, Risk... ...Operations and Performance Improvement leads the operational and analytics... ...(RAF), Stars, HEDIS, and CAHPS initiatives to improve quality outcomes, coding accuracy... ...office environment and/or remotely. The role involves...Remote workHEDISQualitySeniorFull timeWork at office- ...Summary Provides senior level analyst support... ...and opportunities, and improve financial performance.... ...affordability opportunities. Leads projects to completion... ...Keeps abreast of Medicaid and Medicare reforms... ..., disease management, HEDIS quality measures, claims...Remote workHEDISQualitySeniorFull timeWork experience placementWork at office
- ...To support the improvement of kidney care, the remote Quality Improvement Specialist will manage patient and provider panels, deliver actionable performance insights, and drive improvements in HEDIS and Medicare Stars measures through targeted education and collaboration...Remote workHEDISQuality
$79.61k - $172.48k
...Job Summary Provides senior level engineering support... ...supporting Medicare/Medicaid operations. Designs and... ...to derive insights that improve member outcomes. Collaborates... ...and SQL with automated quality assurance testing. •... ..., quality metrics (HEDIS, Stars), and population...Remote workHEDISQualitySeniorFull time- ...This is a fully remote position with a U.S. based company. The Medicaid Team Lead is primarily responsible for overseeing cases... ...performance team, ensure quality of their work, and ensure the... ...necessary Issue Performance Improvement Plans for individual team...Remote workQuality
- ...Salary range will vary for remote positions outside of... ...SUMMARY The RN, Quality Improvement (QI) will support the... ...performance. • Lead the timely investigation... ...DHCS Medical Audits, HEDIS® compliance audits, and... ...setting background • Medicaid Health Plan experience...Remote workHEDISQualityOngoing contractWork from homeVisa sponsorshipWork visaFlexible hours
- ...Technologies is seeking a Senior Manager to lead service delivery and operational execution for Medicaid Claims, Business Policy... ...delivery excellence, quality, and continuous improvement across claims processing... ...client outcomes. Fully Remote - work from anywhere in...Remote jobQualitySenior
$246.36k - $344.91k
...President, Pharmacy, the Senior Director, Pharmaceutical Services leads the strategic direction... ...and continuous quality improvement, while maintaining comprehensive... ..., member experience, HEDIS, Stars and CAHPS... ...schedule. (Monday & Friday - remote, Tuesday - Thursday onsite...Remote workHEDISQualitySeniorContract workTemporary workMonday to FridayFlexible hours$78k - $85k
...Outpatient Quality Improvement Consultant Our client is seeking an Outpatient... ...offers a collaborative, remote-first culture focused on advancing... ...• Experience with HEDIS, preventive care metrics, chronic... ...Associate to Consultant to Senior Consultant levels. Salary...Remote workHEDISQualityMonday to FridayFlexible hours$280.84k - $393.18k
...Health Services, the Senior Medical Director... ..., executing, leading and updating guidelines... ...including quality management, grievance... ...initiatives, and other improvement activities. This... ...but not limited to, HEDIS, CAHPS, and NCQA... ...schedule. (Mon & Fri - remote, Tues - Thurs...Remote workHEDISQualitySeniorTemporary workLocal area$220.04k - $302.54k
...Population Health, the Senior Director,... ...Community Health Improvement efforts. The position... ...mission. Commitment to Quality: The IEHP Team is... ...not limited to, HEDIS, CAHPS, and NCQA Accreditation... ....May have a lead role in IEHP... ...Monday & Friday - remote, Tuesday - Thursday...Remote workHEDISQualitySeniorContract workTemporary workWork at officeLocal areaMonday to Friday$70.1k - $126.2k
...Business Area: Quality Job Type: Full time... ...Position Purpose: The Senior HEDIS Quality & Audit Analyst... ...and audit requirements, leads complex HEDIS audit workstreams... ...flexibility to work remotely within the continental... .... Drive continuous improvement initiatives to...Remote workHEDISQualitySeniorFull timePart timeH1bWork at officeFlexible hours
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