Remote Senior HEDIS Quality & Audit Lead
Centene Management Company LLC
- Remote job
Centene Management Company LLC is seeking a Senior HEDIS Quality & Audit Analyst to lead advanced HEDIS oversight, audit readiness, and submission support across enterprise programs. The role requires interpreting federal/state requirements, guiding audit risk, and coordinating with health plans, auditors, IT, analytics, and quality stakeholders to ensure accurate, timely submissions that meet NCQA and CMS expectations. #J-18808-Ljbffr Centene Management Company LLC
- Centene Corporation seeks a Senior HEDIS Quality & Audit Analyst to lead enterprise HEDIS audit workstreams, ensuring accurate, audit‑defensible documentation and submissions in alignment with NCQA and CMS expectations. You will interpret federal/state regulations, coordinate...Remote jobHEDISQualitySenior
- ...services initiatives, the full-time Senior Quality Improvement Specialist will... ...standards while working remotely across various states during... ...hours. Key responsibilities Leads and manages multiple complex... ...measures such as Star Ratings and HEDIS Required qualifications...Remote workHEDISQualitySeniorFull time
- ...initiatives, the full-time Senior Manager, Quality Operations will manage the Population... ...external stakeholders in a remote capacity. Key... ...key clinical quality metrics Lead strategic projects that advance... ...Quality programs such as MSSP or HEDIS strongly preferred Ability...Remote workHEDISQualitySeniorFull timeContract workWork experience placement
- Molina Healthcare is seeking a remote Sr Quality Improvement/HEDIS Specialist to join their Health Plan Community Interventions team. The ideal candidate will have at least 3 years of healthcare experience and expertise in quality improvement strategies. This role focuses...Remote jobHEDISQualitySenior
- ...Senior Quality Improvement Specialist (RN) Location: NYCLAY (100% remote) Duration: 45 W, 3 D Client: Molina Healthcare... ...Compliance, HEDIS, and / or Quality Reporting... ...Compliance Acts as a lead specialist to provide... ..., CAHPS and state audits by reviewing clinical...Remote workHEDISQualitySenior
$280.84k - $393.18k
...Health Services, the Senior Medical Director... ..., executing, leading and updating guidelines... ...including quality management, grievance... ...leading regulatory audits for all its relevant... ...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, Population Health... ...mission. Commitment to Quality: The IEHP Team is... ...including, but not limited to, HEDIS, CAHPS, and NCQA... ...Cal contract.May have a lead role in IEHP Strategic... ...schedule. (Monday & Friday - remote, Tuesday - Thursday...Remote workHEDISQualitySeniorContract workTemporary workWork at officeLocal areaMonday to Friday$80k - $105k
GPAC in Dallas, TX seeks an experienced Audit Senior Associate to lead audit engagements, review work, and... ...firm. The role focuses on delivering quality audits and supporting firm growth... ...,000-$105,000 with full benefits and hybrid/remote options. #J-18808-Ljbffr gpacRemote jobQualitySenior- ...maintenance of programs for members is in accordance with prescribed quality standards, including conducting data collection, reporting, and... ...in QI planning and project work to further QI goals (e.g., HEDIS activities, strategic planning, and special projects) Provides...Remote workHEDISQualitySeniorContract workWork at officeLocal area
- ...93 Datafied has been a leading document retrieval and... ...oriented and analytical Senior Business Analyst to... ...data collection, data quality validation, and compliance... ...solutions comply with HIPAA, HEDIS, and other relevant... ...periodic reviews Remote-first work culture with...Remote workHEDISQualitySeniorFlexible hours
$72.8k - $130k
...Connecting. Growing together. The Senior Account Manager has geographic responsibility for the quality and economic performance of the... ...and analysis; understanding of HEDIS, Star ratings, accurate... ...am - 5pmLocation: This role is remote in Wichita, KS and requires the...Remote workHEDISQualitySeniorMinimum wageFull timeWork experience placementWork at officeLocal areaMonday to Friday- Senior Clinical Quality Performance Specialist Location: Manchester, NH Primary Job Function: Medical... ...Data and Information Set (HEDIS), and Consumer Assessment of Healthcare... ...in decision-making. Work Arrangement Remote - This position is fully remote; however...Remote workHEDISQualitySeniorWork experience placement
- BeOne Medicines Ltd. is seeking a Senior Manager, GxP Computerized Systems Auditing to lead a global, risk-based audit program for GxP systems across clinical, manufacturing, and quality domains. You will oversee audits of validation, change control, data integrity, cybersecurity...Remote jobQualitySenior
$68.04k - $118.8k
...Summary of Job Support the Quality Management department in the development and maintenance of a monitoring and reporting structure for data reports and analysis related to the HEDIS-QARR project, pharmacy adherence initiatives, and other performance improvement...Remote workHEDISQualitySeniorWork experience placement$80k - $100k
Jobot is seeking an Audit Senior to lead and perform audit engagements for privately held clients, collaborating with managers and partners to deliver high-quality financial statements. This role offers great work-life balance, a lucrative base salary of $80,000-$100,00...Remote jobQualitySeniorWork from homeFlexible hours$49.93k - $90.36k
...JOB DESCRIPTION Job Summary Provides senior level support for health education activities... ...materials, and maintenance of member quality programs. Conducts data collection, reporting... ...Effectiveness Data and Information Set (HEDIS) activities, strategic planning, and...Remote workHEDISQualitySeniorContract workWork experience placementWork at officeLocal areaNight shift- ...Title: Senior Healthcare Informatics Consultant - Pharmacy... ...: Baton Rouge, LA (Remote) Type: Contract... ...benefit utilization, cost, quality, and clinical outcomes.... ..., this position leads complex problem solving... ...related quality metrics (HEDIS medication measures, STAR...Remote workHEDISQualitySeniorContract work
- ...Insurance Company, a Columbus, Ohio-based insurer, seeks a senior Quality Audit leader to direct underwriting quality audits, provide strategic... ...across commercial lines. A Bachelor's degree and 7+ years in underwriting/QA are preferred. #J-18808-Ljbffr Remote JobsRemote workQualitySenior
$91.7k - $163.7k
...removing barriers to quality care. The work you... ...will work with C&S HEDIS measure owners as a Senior Workflow / Alteryx Developer... ...flexibility to work remotely* from anywhere... ...platformsServe as the technical lead on projects;... ...preparation and audit/validation routines...Remote workHEDISQualitySeniorMinimum wageFull timeWork experience placementLocal areaMonday to Friday- ...engineer who can operate at a Senior level: You've built and... ...understand data reliability, quality, and governance as first-class... ...retros, joining our daily 30-min remote stand-up at 7:30am PST (our... ...EHR/EMR, NPI, TEFCA, ADT, HL7, HEDIS, RAF, SNOMED, LOINC, ICD-10, etc...Remote workHEDISQualitySeniorWork at officeWork from homeRelocationFlexible hours
- ...Senior Implementation Engineer Metriport is an open... ...the following specific qualities: You're... ...this looks like: Lead team performance against... ...Attending a daily 30 minute remote stand-up at 7:30am PST... ...NPI, TEFCA, ADT, HL7, HEDIS, RAF, SNOMED, LOINC, ICD...Remote workHEDISQualitySeniorWork at officeWork from homeRelocationFlexible hours
$105.6k - $195.4k
Join to apply for the Senior Manager, Quality Improvement role at Centene... .... This is a remote role with the ideal candidates... ...on annual file audits and other quality related... ...Previous experience as lead in functional area,... ...performance of staff. HEDIS Experience Highly Preferred...Remote workHEDISQualitySeniorFull timeContract workFor contractorsWork at officeFlexible hours- ...Senior Clinical Pharmacist At UnitedHealthcare, we... ...and removing barriers to quality care. The work you do... ...care programs including HEDIS and CMS Stars programs... ...performance management results, audit results, CMS reporting,... ...*All employees working remotely will be required to...Remote jobHEDISQualitySeniorHourly payMinimum wageFull timeWork experience placementLocal areaMonday to Friday
$243.8k - $304.8k
...Senior Director, Clinical and Translational Research Remote, USA Omada Health is on a mission to inspire... ...Translational Research leads Omada’s efforts to... ...program experiments and quality improvement projects in... ...measurement frameworks such as HEDIS and Medicare Advantage...Remote workHEDISQualitySeniorLocal areaWork from homeFlexible hours$78.8k - $177.68k
...partner is looking for a Senior Account Manager/Sr.... ...payer organizations. Lead regular client meetings... ...cost-of-care analytics, quality measurement, utilization... .... ~ Familiarity with HEDIS, population health,... ...discretionary bonus program. ~ Remote work flexibility within...Remote workHEDISQualitySeniorFull timeTemporary workFlexible hours$126.3k - $173.7k
...locations. In this remote position, you will report... .... Engage in quality improvement initiatives... ...Support CMS Stars and HEDIS quality measures for successful... ...About Us About Conviva Senior Primary Care: Conviva... ...: CenterWell is a leading healthcare services business...Remote workHEDISQualitySeniorTemporary workApprenticeshipWork from homeHome office- Position Summary The Senior Health Insurance Contract Specialist leads the development, negotiation... ..., operational readiness, quality performance, and long-term... ...utilization management, audit rights, dispute resolution... ...provisions with HEDIS, CMS Stars, risk adjustment...Remote workHEDISQualitySeniorContract workLocal area
- Audit Senior/Manager - Public Accounting - HybridScottsdale, AZMust-HavesBachelor... ...experience planning, leading, and completing audit... ...and a highly flexible hybrid/remote work environment.The ideal candidate... ...and partners to ensure high-quality client deliverablesMaintain strong...Remote workQualitySeniorFlexible hours
- Senior Software Engineer San Francisco, CA Metriport... ...the following specific qualities: You’re entrepreneurial... ...the ability to lead others. You care more... ...Attending a daily 30 minute remote stand-up at 7:30am PST... ...NPI, TEFCA, ADT, HL7, HEDIS, RAF, SNOMED, LOINC, ICD...Remote workHEDISQualitySeniorWork at officeWork from homeRelocationFlexible hours
- • Completes member-facing HEDIS interventions telephonically, including outreach, education... ...-up to support measure compliance and quality outcomes • Performs monthly, quarterly, annual and ad hoc medical record chart audits of appeals, approvals, denials, and integrated...HEDISQualitySenior
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