Remote Clinical Quality Consultant: HEDIS & STARs
Texas Health Institute
- Remote job
OptumCare, a UnitedHealth Group company, seeks a Clinical Quality Consultant (CQC) to drive clinical relationships and engagement with account management, quality nurses, physician practices, members and pharmacies, aiming to improve health outcomes while reducing costs through data analytics and targeted education. Primary responsibilities include analyzing HEDIS and STARs reporting, participating in regular business reviews, evaluating provider group structures to improve STAR measures, #J-18808-Ljbffr Texas Health Institute
$60.2k - $107.4k
...Clinical Quality Consultant For those who want to invent the future of health care, here's your... ...but is not limited to improvement on HEDIS and STARs gap closure, coding accuracy, facilitating... ...will have the flexibility to work remotely* as you take on some tough...Remote jobHEDISMinimum wageFull timeContract workWork experience placementWork at officeLocal areaMonday to Friday$124k - $280k
...SectorHealth ServicesSpecialismOperationsManagement LevelSenior ManagerJob Description & SummaryThe OpportunityAs a Payer STARS/Quality Clinical Consultant, Senior Manager, you will engage with clients in the health services sector, providing strategic guidance and...SuggestedFull timeH1b$112.7k - $193.2k
...00 - $193,200/yearJob Area: Medical & Clinical OperationsCompany: UnitedHealth GroupOptum... .... Growing together.The Clinical Quality Consultant for the Oncogenetic Program provides guidance... ....You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you...Remote workMinimum wageFull timeWork experience placementLocal area$78k - $85k
...Outpatient Quality Improvement Consultant Our client is seeking an Outpatient Quality... ...practices, outpatient clinics, and ambulatory healthcare... ...organization offers a collaborative, remote-first culture focused on... ...• Experience with HEDIS, preventive care metrics, chronic...Remote workHEDISMonday to FridayFlexible hours$91.7k - $163.7k
...pharmacy benefit analysis and consultation delivery to clients.... ...-to-day service delivery for clinical pharmacy needs. Represents client... ...enjoy the flexibility to work remotely * from anywhere within the U.... ...formulary compliance targets, and HEDIS & NCQA measuresProvide...Remote workHEDISMinimum wageOngoing contractFull timeWork experience placementWork at officeLocal area- UnitedHealth Group's Optum division seeks a Clinical Quality Consultant for the Oncogenetic Program. You will provide guidance on utilization management... ...in a fast-paced, technology-driven environment. Remote work from anywhere in the U.S. #J-18808-Ljbffr RXinsider...Remote job
- UnitedHealthcare is seeking a Clinical Practice Consultant to improve clinical quality outcomes and engage providers across Washington state. The role focuses... ...to 50% across Washington, with the option to work remotely within the state. You will partner with providers,...Remote job
$91.7k - $163.7k
...Accreditation And Regulatory Related Clinical Quality Improvement At UnitedHealthcare, we're simplifying the health care experience, creating... ...requirements. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal area- ...Clinical Practice Consultant At UnitedHealthcare, we're simplifying the health... ...communities and removing barriers to quality care. The work you do here... ...the flexibility to work remotely* as you take on some tough... ...expert (SME) for assigned HEDIS/State Measures, preventive...Remote jobHEDISHourly payMinimum wageFull timeWork experience placementWork at officeLocal area
- ...overarching strategy to provide quality and cost-effective... ...management based on clinical judgment, changes in... .... ~ May provide consultation, resources and recommendations... ...closing care gaps (HEDIS measures, medication... ...Understanding of CMS Star Ratings methodology and...Remote jobHEDISWork at officeLocal area
$134.6k - $230.8k
...costs while improving risk management, quality and revenue growth. Ready to help us... ...NCQA Health Plan Ratings (with HEDIS at the core), CMS Stars, the CMS Quality Rating System (QRS),... ...You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you...Remote jobHEDISMinimum wageFull timeWork experience placementWork at officeLocal area$115.2k - $158.4k
...relationships and/or improved quality metrics. The Program... ...to substantial. The Stars In-Home Program... ...delivering and increasing the clinical value of the in home... ...or a related field HEDIS experience PMP certification... ...: While this is a remote position, occasional...Remote workHEDISBi-weekly payTemporary workApprenticeshipWork at officeWork from homeHome office- Join to apply for the Clinical Transformation Consultant role at Innovaccer The Clinical... ...—care management, quality improvement, chronic disease... ...compliance requirements (e.g., HEDIS, CMS, value‑based care models... ...Comfortable with online & remote schedules. Preferred...Remote workHEDISTemporary workLocal areaImmediate start
- ...granted as required by law. Responsible for quality documentation, coding and value capture.... ...to: Focus on chart reviews by supplying clinical expertise to ensure full accurate and... ...documentation. Chart reviews for closing HEDIS care opportunities. Liaison to coding...HEDISFull timeTemporary workWork at officeLocal area1 day per week
- ...To support a growing healthcare initiative, the remote Quality Improvement Specialist will manage patient and provider panels, deliver performance insights, and drive improvements in HEDIS and Medicare Stars measures through education and collaboration. Key responsibilities...Remote workHEDIS
- ...initiatives, the full-time Senior Quality Improvement Specialist will... ...standards while working remotely across various states... ...delivery Ensures compliance of clinical and service quality... ...performance measures such as Star Ratings and HEDIS Required qualifications Bachelor...Remote workHEDISFull time
$27.02 - $48.55 per hour
...regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides... ..., enhances and maintains provider clinical relationship across product lines. Maintains... ...flexible approach to work with remote, hybrid, field or office work schedules...Remote workHEDISHourly payWork at officeFlexible hours- EmblemHealth seeks a data analytics professional to support Quality Management by developing and maintaining monitoring and reporting structures for HEDIS-QARR, Medicare Stars, Medicaid QIA, and related initiatives. You will generate meaningful insights and actionable analytics...HEDIS
- ...Overview: Data Quality Analyst Location: Remote Duration: 3-6+ months (possible extension) Position Summary We are seeking experienced... ...healthcare or health plan data (claims, enrollment, HEDIS/Stars). Familiarity with QA automation tools and...Remote workHEDIS
- ...Eligible Special Needs Plan (D-SNP) populations, the full-time Remote Clinical Program and Population Health Strategist will develop and... ...Medicare (D-SNP) and/or Medicaid programs Strong understanding of HEDIS, Stars, risk adjustment, and utilization drivers Experience...Remote workHEDISFull time
$4,000 - $5,000 per month
...and engineering. You'll work closely with Clinical, Operations, Data, Client Services, and... ...workflows, or healthcare operations. HEDIS, STARS, Medicare, or Medicaid experience.... ...Government-mandated benefits Fully remote within Latin America. Help build technology...Remote workHEDIS- ...initiatives, risk adjustment efforts, and quality programs within a contracted... ...South Carolina or Georgia, with remote work options for some candidates... ...Officer and collaborate with clinical, operations, and finance leaders to drive STAR/HEDIS performance and program delivery...Remote workHEDIS
- ...Responsible for the HEDIS Medical Record Review process... ...while working remotely. Key responsibilities: Review and abstract clinical data from electronic medical... ...audit preparation and quality reviews Required qualifications... ...lines of business and Stars Measures Strong Excel...Remote workHEDISFull time
$100k - $120k
...Work Fully Remote While Owning Payer Client Relationships In Value-Based CareRole SnapshotClient Services Manager • RemotePay:... ...readyNice To HavePayer or payer-services backgroundFamiliar with HEDIS/STAR (quality measures) or risk adjustmentExperience with reporting or BI...Remote workHEDIS- ...Quality Improvement SpecialistCompletes quality improvement activities... ...patients' demographic, clinical, and financial... ...improvement programs such as: HEDIS, Medicare 5 Star, Meaningful UseAbility to use... ...role works primarily in a remote capacity and has daily communications...Remote workHEDISWork at officeLocal areaShift work
- CVS Health is seeking a Quality Practice Liaison for a work-at-home... ...Mercy Care Plan. You will present HEDIS gaps in care, educate on... ...The role requires NCQA HEDIS/STAR familiarity and ability to work... ...hold an RN license with 3+ years clinical experience, 2+ years HEDIS experience...Remote jobHEDIS
- ...Empire Health Plan in California seeks a Quality Improvement Measure Strategist to drive initiatives that enhance performance on HEDIS, CAHPS, and NCQA accreditation. You will analyze... ...and external partners to achieve 4-star measure performance and support IEHP’s quality...Remote jobHEDIS
$320k - $350k
...Medical Director serves as a key clinical executive within the health... ...expertise to ensure high‑quality, cost‑effective care for members... ...initiatives, including HEDIS, Stars, NCQA, and other performance... ...Additional Job Details (if applicable)Remote TypeRemoteWork Location399...Remote workHEDISFull time$42.26 - $45.78 per hour
...We are looking for a Clinical Pharmacist to join our growing team. You will be offered a competitive... ...dedicated clinical resource responsible for quality measures supporting the pharmacy department in identifying Star/HEDIS measure needs and expectations, and developing...Remote workHEDISHourly pay- ...Summary of Job Support the Quality Management department in the development and maintenance... ...data reports and analysis related to the HEDIS-QARR project, pharmacy adherence... ...improvement initiatives related to Medicare Stars and Medicaid QIA. Provide analysis of HEDIS...Remote workHEDISWork experience placement
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