HEDIS Clinical Quality Manager - Telecommute
$79.7k - $142.6kUnitedHealth Group
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:Assist with the implementation of the HEDIS program for vision, including the HEDIS data collection and clinical improvement projects Participate in determination of annual HEDIS strategy as well as other clinical improvements Participate with Vision’s HEDIS Team to identify and implement region and or state-specific projects to improve HEDIS scores, CMS Star Ratings and other metrics.Identify opportunities and actively participate in process improvements related to enhancing quality Assist in developing targeted educational reminders for clinical/preventive initiatives Vendor Oversight at the Project levelYou'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:Undergraduate degree or equivalent work experience2+ years HEDIS experience or development of clinical programs2+ years of experience working with Medicare or Medicaid, vision experience a plus2+ years managing projects from initial strategy through implementationDemonstrated ability to assist with focusing activities toward a strategic direction and achieve targetsIntermediate to advanced level proficiency with Microsoft Word, Excel and PowerPointIf you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking ordersPreferred Qualifications:2+ years HEDIS experience and/or knowledge Experience working with HEDIS software vendors (management, building relationships, issue resolution etc.)Knowledge of CMS STARs Soft Skills:Proven data management and/or project management skills Excellent interpersonal skills Excellent time management and prioritization skills Excellent written and verbal communications skills Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.SMColorado Residents Only: The salary range for Colorado residents is $79,700 to $142,600. Role is also eligible to receive bonuses based on sales performance. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, in addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.For more information on our Internal Job Posting Policy, click here.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.Job Keywords: Manager, Supervisor, Leadership, Quality, Quality Improvement, Process Improvement, Performance Improvement, Auditing, Health Care Analytics, Managed Care, Healthcare, HEDIS, Project Management, Medicaid, Medicare, CMS, STARs, Telecommute, Work from Home, UHG, UHC, UnitedHealthcareBrand: Employer & IndividualJob ID: 934081Employment Type: Full-timeJob Area: Clinical
$83.1k - $120.36k
...The Clinical Quality Manager with members and providers to ensure members receive appropriate services. This role emphasizes improving the quality of care with a focus on HEDIS, QARR and Medicare Advantage Star measures. Interacts with hospitals, providers, and members...HEDISTemporary workWork experience placement- ...Infrastructure Optimization and the Chief Medical Officer, the Clinical Quality Manager is instrumental in the design, measurement/monitoring,... ...nationally required quality performance metrics, including HEDIS and customized state measures. Oversight of external contractors...HEDISFor contractorsLocal areaMonday to Friday
- ...experience that is smarter, faster, and more personalized. The Clinical Program and Quality Manager is a registered nurse who is responsible for providing... ...—ensuring care and documentation consistently meet HEDIS/CMS, client, and internal SOP standards. This...HEDISContract workFor contractorsWork at office
$78.7k - $134.9k
...connected care, where coordinated, quality service is the norm and every... ...for leading day-to-day clinical review and medical record operations... ..., coaching, and workload management for Clinical Quality Review... ...accreditation requirements, HEDIS & STAR measurements, RADV, correct...Remote workHEDISWork experience placement- ...Job Description Job Description Clinical Quality Manager Location: Grand Valley Medical Specialists (GVMS), Grand Rapids, MI Employment... ...incentive programs, and value-based care initiatives, including HEDIS, MIPS, Medicare Star Ratings, ACO, PCMH, PGIP and PIP...HEDISFull timeWork at office
- ...Position Type: Remote, centralized position supporting multiple branch clinical field teams. Position Overview The Clinical Quality Manager is a centralized, remote RN role that provides clinical backbone support to the field clinical team. This is not a field...Remote work
- ...Description Job Description Position: RN Clinical Quality ManagerLocation: Hybrid (Must Reside in... ...in need of continuing care and managed care services.Our mission is to promote... ...work for MLTC or Medicare products; drive HEDIS/Stars gap closure- Analyze claims and...HEDISMonday to Friday
$105.6k - $195.4k
...Join to apply for the Senior Manager, Quality Improvement role at Centene Corporation Join to apply for the Senior Manager, Quality... ...training, assigning work and managing the performance of staff. HEDIS Experience Highly Preferred Pay Range $105,600.00 - $195,4...Remote workHEDISFull timeContract workFor contractorsWork at officeFlexible hours- ...To ensure compliance and quality in clinical trials, the remote Clinical Quality Compliance Manager will manage the Quality Management System (QMS), oversee quality operations, and lead a high-performing quality team while maintaining regulatory standards. Key responsibilities...Remote work
$66.46k - $129.59k
**Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team.... ...timelines and implementing solutions to maximize national HEDIS audit success. - Partner with other teams to ensure data...Remote workHEDISWork experience placementWork at office$91.7k - $163.7k
...Connecting. Growing together. Job Description - Manager Clinical Operations - Metairie, LA Market (23712... ...communities and removing barriers to quality care. The work you do here impacts the... ..., improve and maintain quality metrics(HEDIS, STARS, etc.) Supports the development...Remote workHEDISMinimum wageFull timeWork experience placementWork at officeLocal areaMonday to Friday$85k - $110k
...optometry, dermatology, case management/care coordination, supplemental... ...,000.00 Position Summary The Quality Improvement (QI) Manager... ...insights that drive operational, clinical, and strategic decision-... ...quality requirements (e.g., HEDIS, UDS, CMS). Supports audit readiness...Remote workHEDISFlexible hours- ...work with the leading medical research center in the world. We are seeking an experienced individual to work as a Clinical Research Quality Assurance Manager at the National Institutes of Health in Rockville, MD. This position is estimated to support a hybrid work...Remote workLong term contractFull timeTemporary workFor contractorsDay shift
$80k - $85k
...Clinical Quality Assurance Manager Farmington Hills, Michigan, United States; Michigan, United States Remote Eligible- Must be located in Michigan within distance of Farmington Hills. Position Summary The Clinical Quality Assurance Manager plays a crucial...Remote workWork experience placementWork at officeMonday to FridayShift work$85k - $110k
Job Category: QUALITY IMPROVEMENT SERVICES Requisition Number: QUALI... ...optometry, dermatology, case management/care coordination,... ...Officer, Chief Medical Officer, clinical teams, and operational leaders... ...quality requirements (e.g., HEDIS, UDS, Medi‑Cal MCPs, CalAIM)....Remote workHEDISFull timeFlexible hoursShift work- ...operational workflows, the full-time remote Manager, Market Performance will drive value-... ...including hospital discharge follow-ups and HEDIS outreach Monitors team performance... ...of experience in healthcare operations, clinic management, or a related service-oriented...Remote workHEDISFull timeShift work
- ...health initiatives, risk adjustment efforts, and quality programs within a contracted network. The role is... ...America Chief Medical Officer and collaborate with clinical, operations, and finance leaders to drive STAR/HEDIS performance and program delivery. #J-18808-LjbffrRemote workHEDIS
$238.83k - $341.19k
...best primary care providers and clinical leaders that are seeking to... ...score (patient experience), HEDIS and clinical gaps closures, and... ..., as well as support Center Manager/Center General Manager. The... ...physicians to improve clinical quality, efficiency, outcomes, cost...HEDISHourly payFull timeTemporary workWork at office$280.84k - $393.18k
...oversight of IEHP Medical Policies and clinical leadership around member health outcomes... ...related to key activities including quality management, grievance and appeals, delegation oversight... ...goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation....Remote workHEDISTemporary workLocal area- ...Centene Corp. seeks a Director of Quality & Process Improvement to lead HEDIS audit readiness and process improvement initiatives. This position involves working with cross-functional teams to ensure compliance and timely submissions. Applicants should have over 6 years...Remote workHEDIS
$220.04k - $302.54k
...oversight over population health management regulatory requirements... ...social mission. Commitment to Quality: The IEHP Team is committed to... ...including, but not limited to, HEDIS, CAHPS, and NCQA... ...unrestricted, and unencumbered clinical licensure issued by the appropriate...Remote workHEDISContract workTemporary workWork at officeLocal areaMonday to Friday- ...senior leadership and the corporate network management team to develop and implement... ...provider community that result in high quality, cost-effective and marketable providers... ...Healthcare Effectiveness Data Information Set (HEDIS) initiatives and regulations. • Hires,...Remote workHEDISContract workWork at office
$130.56k - $208.9k
...of Healthcare Payer/Provider clinical data exchange you will own and... ...applicants. You will lead and manage IT teams through successful delivery... ...recommendations that ensure quality, cost effectiveness, goals,... ...Gaps, Risk Adjustment (HCCs) HEDIS, FHIR Implementation Guides,...Remote workHEDISFull timeWork at officeLocal areaFlexible hours2 days per week- ...Corporation is looking for a qualified candidate to lead process improvement initiatives and ensure HEDIS audit readiness. This role requires deep experience in managing regulatory timelines and delivering accurate results across health operations. The ideal candidate will...Remote jobHEDIS
$140k - $230k
...the U.S. with a strong reputation for quality of care and research and education. Our... ...health analytics and operations, care management, clinical integration, and population-based quality... ...teamsExpertise in pharmacy utilization management, HEDIS/Star Ratings quality performance, and...Remote workHEDISFull timeContract workTraineeshipLocal areaShift work$286.07k - $353.38k
..., Health Plan provides senior clinical leadership across the Health Plan, with a focus on quality, affordability, compliance, clinical... ...leadership across utilization management, care management, population... ...bids, risk adjustment, STARS, HEDIS, value-based arrangements, and...Remote workHEDISFull timeHome office- ...Overview The role of the Quality Assurance Coordinator (QA Coordinator) is to monitor... ...Coordinator to have knowledge of 5 STAR, PQRS, HEDIS, CMS coding guidelines, and coding/... ...quality initiatives as needed. Process and manage member and provider communications as...HEDISFull timeApprenticeshipWork at officeLocal areaMonday to FridayShift workDay shift
$135.2k - $179.13k
...an authentic experience!The Supervisor, Quality Engineering is both a leadership and hands... ...-on QE role with excellent relationship management skills to successfully supervise daily... ...Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation....Remote workHEDISTemporary workMonday to Friday$112.7k - $193.2k
...Growing together. This Associate Director of Clinical Consulting will oversee clinical... ...proactively identify clinical solutions, and manage clinical resource allocation for one or more... ..., formulary compliance targets, and HEDIS & NCQA measuresFormulates and delivers clinically...Remote workHEDISMinimum wageFull timeWork experience placementLocal area- ...flexibility by offering contingent labor as a variable cost.Job DescriptionJob Description: The correct title for this position is Clinical Quality Manager. Role Description The Clinical Quality Manager (CQM) is responsible for driving Asset and Study level quality management...Work at officeImmediate start
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