Average salary: $72,638 /yearly
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- ...incentive rewards returned to physicians in West Michigan ~ Access to technological and quality-improvement infrastructure ~95% HEDIS performance & top PO on payer contracting ~ Formed by the Physicians’ Organization of Western Michigan (POWM) and West Michigan Physicians...HEDISPrivate practiceWork at officeLocal area
Enterprise Medical Recruiting
Grand Rapids, MI21 days ago - Karmanos Cancer Institute, part of McLaren Health Care, is looking for a National Committee for Quality Assurance Specialist. This role is centered around quality improvement activities and compliance with regulatory standards within a managed care setting. Qualified candidates...HEDISFull time
Karmanos Cancer Institute
Flint, MI3 days ago - ...facilities improve patient outcomes and achieve their goals by connecting them with highly skilled and qualified professionals. HEDIS Course We are offering a HEDIS course to individuals looking to start working as a HEDIS Abstractor. Once the course is completed...HEDISRemote work
Confident Staff Solutions
Flint, MI2 days ago - Karmanos Cancer Institute is seeking a Quality Administrator to enhance quality management operations. The role involves coordinating regulatory responsibilities and providing insights to quality committees while fostering a culture of quality improvement. The ideal candidate...HEDIS
Karmanos Cancer Institute
Flint, MI3 days ago - ...experience required Hospital experience strongly desired due to case types knowledgeable in ICD-9/ICD-10-CM/PCS, CPT-4/HCPCS, HCC and HEDIS CAT II, Risk Adjustment knowledge & proficiency of EPIC EHR and 3M 360 coding is encouraged ability to assign CPT codes...HEDISRemote work
3B Healthcare, Inc.
Traverse City, MI5 days ago - ...Summary: The Clinical Quality Specialist RN is responsible for clinical elements of the PQI process for the Plan, participating in the HEDIS process, participating in NCQA activities, as well as implementing quality interventions and conducting evaluation to ensure on-...HEDIS
McLaren Medical Group
Flint, MI1 day ago - ...provider in Southfield, Michigan is seeking a Quality Specialist. The role requires strong data analysis skills and experience with HEDIS and Gaps in Care measures. Responsibilities include monitoring quality standards for patient care, collaborating with vendors, and providing...HEDIS
$135k
...Provide care in nursing and long-term care facilities Manage chronic conditions and perform full assessments Close care gaps (HEDIS and STAR measures) Lead care planning with facility teams Support and educate patients' families Must-Haves ~ Active...HEDISUrrly
Saginaw, MI4 days ago- ...Experience in ACO, population health, or value-based care Case management experience Familiarity with quality metrics (HEDIS, CMS, etc.) Certification (CCM, ACM, or similar) Why This Role Matters This is where healthcare is going. You'll help patients...HEDIS
INSIGHT HEALTH SYSTEMS, INC.
Coldwater, MI2 days ago - ...quality operations. Coordinates specific regulatory and contractual responsibilities of assigned HMO including, but not limited to, HEDIS, CAHPS, NCQA Standard compliance, state performance projects, site audits and any other regulatory agencies. #LI-KH1 Qualifications...HEDISWork experience placement
McLaren USA
Flint, MI1 day ago - ...- Follow rooming procedure including asking about recent ER/Hospital visits, taking vital signs, reviewing medication list and due HEDIS or UDS measures, completing screening tests and health maintenance orders as identified in the chart preparation. Record in the EHR...HEDISRelief
FAMILY HEALTH CARE CENTER OF KALAMAZOO
Kalamazoo, MI3 days ago - ...Suite and web-based programs. Understanding of health plan functions related to utilization, care, and quality management as well as HEDIS/STARs and NCQA. Familiarity with CMS regulations and standards. Basic knowledge of evidence-based clinical decision support...HEDISWork at office
Advantasure
Detroit, MI1 day ago - ...enters information into required databases. • Assists the team in defining and working toward identified quality indicators (e.g., HEDIS/UDS, North Star, PCI initiative). • Attends required in-service training and departmental meetings. • Follows up on hospital...HEDISWork at office
FAMILY HEALTH CARE CENTER of KALAMAZOO
Kalamazoo, MI3 days ago - ...organization or a managed care setting, with at least two (2) years’ experience performing complex quality management activities including HEDIS, NCQA, etc. Preferred: Bachelor’s in healthcare or related field. Experience writing quantitative and qualitative analysis....HEDISFull timePart timeWork experience placement
Karmanos Cancer Institute
Flint, MI3 days ago - ...Medicaid, Exchange, and D-SNP populations. This role requires a deep expertise in Medicaid and Medicare quality programs, including HEDIS, HOS, STAR, and CAHPS, and a proven track record in driving measurable improvements in these areas. The Senior Director will also be...HEDIS
- ...to prevent or resolve problems or concerns.6. Works with the Quality Coordinator auditing and monitoring meaningful uses measures, HEDIS performance and other quality issues.7. Follows universal precautions.8. Establishes an interpersonal relationship with individuals...HEDISShift workWeekend work
- ...hospitalizations Facilitate and administer health plan clinical operations: prior authorization, Part A and B services, medication reviews, HEDIS and STARs quality gap closure, and promote membership growth Serve as a trusted advisor to members, loved ones, and nursing home...HEDIS
- ...Facilitates and administers Health Plan clinical operations functions—prior authorization, Part A and B services, medication reviews, HEDIS and STARs quality gap closure, and promotes membership growth Serves as a trusted advisor to members, loved ones and nursing home...HEDIS
- ...functions. Clinical Quality Measurement and Validation (30%) Lead the validation of clinical quality measures across GLBHC (UDS, HEDIS, HRSA, state and health plan measures), confirming that denominator and numerator logic is applied correctly and reflects actual...HEDISFull timeFlexible hours
Great Lakes Bay
Saginaw, MI1 day ago $26.5 - $47.59 per hour
...perspective on workplace flexibility. Position Purpose Lead data collection and abstraction for company quality measures, including HEDIS, CMS, CHIPRA and other custom measurements. Assess vendor‐delegated abstraction activities and compare results to HEDIS standards and...HEDISHourly payFull timePart timeWork at officeRemote workFlexible hoursMeridian
Lansing, MI12 hours ago- ...needed. # Provides and process records in accordance with HIPPA and PHI (Protected Health Information) disclosures. May comply with HEDIS audit information process requests as needed. Other Functions: Performs other duties as assigned. During a public health...HEDISWork at office
Ingham County Michigan
Lansing, MI3 days ago - ...provider, provide patient health counseling and instruction. # Maintains a general understanding of UDS measures, MQIC guidelines, HEDIS measures, PCMH and NCQA standards. Utilizes appropriate resources to guide practice, i.e., Lippincott manual, MQIC guidelines, etc....HEDISFull timeTemporary work
Alcona Health Centers
Lincoln, MI3 days ago $73.6k - $123.2k
...Job Description The HEDIS Improvement Team supports quality improvement initiatives with a primary focus on Stars performance. The team partners closely with Clinical Operations to identify opportunities for improvement, develop actionable insights, and measure the...HEDISContract workEmergent Holdings
Lansing, MI3 days ago- ...Preferred Experience: 3+ years' experience in an administrative support role in healthcare, Medical Assistant preferred, basic knowledge of HEDIS and NCQA Must have a valid driver's license with good driving record and be able to drive within applicable state or locality...HEDISTemporary workLive inWork at officeRemote work
- ...quality of care for DWIHN members. The Medical Director will monitor compliance with quality metrics including but not limited to HEDIS measures and other quality indicators. They will participate in Root Cause Analysis and special Quality Assurance reviews. The...HEDISTraineeshipLocal areaWeekend work
Community Mental Health Partnership of Southeast Michigan
Wayne, MI1 day ago - ...level administration and management of healthcare clinical measurement utilizing Healthcare Effectiveness Data and Information Set (HEDIS), National Perinatal Information Center (NPIC), National Surgical Improvement Program (NSQIP), Trauma Quality Improvement Program (TQIP...HEDISFull timeContract workFor contractorsWork at officeLocal areaRemote workMonday to Friday
St. George Tanaq Corporation
Lansing, MI12 hours ago - ...care, managed care, or quality improvement. Understanding of APM concepts such as shared savings, bundled payments, risk adjustment, HEDIS measures, and value‑based contracts. Strong analytical, organizational, and project coordination skills. Proficiency with...HEDISContract workShift work
- ...groups. PRINCIPLE DUTIES AND RESPONSIBILITIES: Develops and presents PHO/PO reports related to risk adjustment, quality including HEDIS/Medicare 5 Star performance, financial and utilization metrics. Analyzes data and makes recommendations to contracted provider groups...HEDISContract workShift work
- ...audiences. Design, implement, and manage comprehensive provider incentives programs in compliance with CMS regulations to improve HEDIS rates, cost efficiency, and APM business goals. Oversee and report on interventions for specific quality measures and maintain strategy...HEDISContract workTemporary workLocal areaShift work
- ...and goals. Promotes quality of care for DWIHN members. Monitors compliance with quality metrics including but not limited to HEDIS measures and other quality indicators. Participates in Root Cause Analysis and special Quality Assurance reviews. Provides consultations...HEDISFull timeTraineeshipLocal areaWeekend work
Detroit Wayne Mental Health Authority
Detroit, MI4 days ago
