Average salary: $118,816 /yearly
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- A leading healthcare organization is seeking a Manager of Quality Management to oversee the compliance and quality initiatives within the plan. This role involves direct supervision of staff, compliance with NCQA standards, and implementation of quality improvement programs...HEDIS
$2,340 per week
...planning, and utilization review Must have knowledge of InterQual & Milliman Guidelines Strong understanding of regulatory standards (CMS, HEDIS, NCQA, ICD-10, CPT) Experience with acute care, LTAC, rehab, or skilled nursing settings Ability to develop care plans, conduct...HEDISWeekly payLong term contractPermanent employmentTemporary workWork at officeShift workLanceSoft
Mount Rainier, MD6 days ago- ...Milliman Guidelines; previous Charge experience preferred - Regulatory skills required: knowledge of CPT codes, Department of Health DRG, HEDIS measures, NCQA, OSHA procedures and JCC - *unit will take FIRST TIME TRAVELER* must present with strong background Unit Information:...HEDISCasual workLocal areaShift workWeekend work2 days per week
Windsor Healthcare Recruitment Group, Inc.
Washington DC4 hours ago - ...initiatives focused on clinical data and performance improvement. The role entails managing projects related to clinical data integration, HEDIS processes, and stakeholder engagement. Ideal candidates will have over 5 years of experience in a health plan and strong analytical...HEDIS
- ...tracks high-risk referrals, lab tests, organizes practice environment to assure patient safety and quality outcomes, and contributes to HEDIS and designated quality measures. Location: 6410 Rockledge Drive, Ste 200 Bethesda, MD 20817 (Position will require travel to...HEDISFull timeLocal areaShift work
Johns Hopkins HealthCare
Bethesda, MD1 day ago - ...or healthcare analytics. Strong understanding of claims data, cost/utilization modeling, and quality measurement frameworks (e.g., HEDIS, Stars, MLR). Proven ability to translate data insights into operational programs. Experience partnering with clinicians and care teams...HEDISContract workRemote work
Chamber
Washington DC4 hours ago - ...facilitates safe transitions of care, organizes practice environment to assure patient safety and quality outcomes, and contributes to HEDIS and designated quality measures. Location : 1400 "I" Street St. NW, Washington, D.C. 20005 Shift : Non-exempt. -...HEDISFull timeLocal areaShift work
Johns Hopkins HealthCare
Washington DC4 days ago - ...facilitates safe transitions of care, organizes practice environment to assure patient safety and quality outcomes, and contributes to HEDIS and designated quality measures. What awaits you! ~ Medical, Dental, Vision ~403B Savings Plan ~ Paid Time off & Paid...HEDISFull timeLocal areaShift workDay shift
Johns Hopkins Medicine
Arlington, VA4 days ago - ...quality activities related to Quality Management. This includes managing medical policy development, quality of care, health promotion, HEDIS interventions, accreditation as well as committee structure and support. Accountabilities: Responsible for the development,...HEDISContract workWork experience placement
Careers Integrated Resources Inc
Washington DC3 days ago - ...quality initiatives Lead the end-to-end delivery of large, complex Medicaid quality measurement and population health programs, including HEDIS, CMS Core Sets, and value-based payment initiatives Oversee multi-scope, data-intensive contracts encompassing measure development,...HEDISContract workLive inRemote work
Telligen
Washington DC3 days ago - ...solutions. Foster productive partnerships with providers around supplemental data feeds. The clinical data acquisition will support the HEDIS/Stars program, Risk adjustment, and population health strategies. Quality Analytics: ensure a strong partnership with data/analytics...HEDISFull timeRemote workDay shift
Johns Hopkins Health Plans
Washington DC4 hours ago $59.81k - $129.59k
...all regulatory audit guidelines by adhering to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success. Partner with other teams to ensure data quality through sequential transformations and identify opportunities to...HEDISWork experience placementWork at officeMolina Healthcare
Washington DC1 day ago- ...medicine at any Mary’s Center location as per the direction of Medical Leadership Practice medicine within quality standards such as HEDIS Coordinate for sub-specialty care with the nursing and social work staff Provide consultation and education to patients and/or...HEDISPermanent employmentWork at officeRemote workAfternoon shift
Mary's Center
Washington DC3 days ago - ...external healthcare providers as necessary to make appropriate medical decisions. Practice medicine within quality standards such as HEDIS Coordinate for sub-specialty care with the nursing and social work staff Provide consultation and education to patients and/or...HEDISWork at officeRemote workAfternoon shift
Mary's Center
Washington DC4 hours ago - ...external healthcare providers as necessary to make appropriate medical decisions. Practice medicine within quality standards such as HEDIS Coordinate for sub-specialty care with the nursing and social work staff Provide consultation and education to patients and/or...HEDISWork at officeRemote workAfternoon shift
Mary's Center
Washington DC4 hours ago - ...patient facing. If selected for this role, you will be required to be screened for TB PREFERRED QUALIFICATIONS: Knowledge of HEDIS/STARS Knowledge of CAHPS and HOS Experience working in medically underserved/culturally diverse communities...HEDISTemporary workLocal area
Sage Health
Riverdale, MD3 days ago $54.36k - $77.66k
...analytics and dashboards to assist with the development and execution of business strategies that increase revenue and quality ratings (HEDIS/STARS/Clinical Gaps) and support our core model. Develops protocols and procedures to improve staff productivity. Collaborates...HEDISHourly payFull timeWork experience placementWork at officeRelocation packageFlexible hoursShift workChenMed
Arlington, VA4 days ago$103.68k - $149.13k
This role leads and supports quality strategy and operations initiatives focused on clinical data, HEDIS processes, and performance improvement. Responsibilities include managing projects related to data integration, HEDIS abstraction, NCQA audit support, clinical reporting...HEDISWork experience placement$102.7k - $140k
...assurance initiatives based on survey results. Supports the Quality Management Department and Company-wide Quality Initiatives such as HEDIS, CAHPS and NCQA/URAC: Reviews Quality indicators and makes recommendations for improvement Compiles documentation regarding...HEDISContract workWork at officeRemote workFlexible hoursAmeriHealth Caritas
Washington DC4 hours ago- ...quality and productivity. Specifically focused on retrieval projects for health plan and CMS campaigns, including but not limited to: HEDIS, DRG, Risk Adjustment, Payment Integrity, RAC, CMS Audits Receive and review audit requests from external entities, ensuring...HEDISRemote job
$94.9k - $130.5k
...data source selection of a complex Test Kit platform that serves members in home options that drive member measure compliance to CMS HEDIS Stars measures. This role bridges product ownership, data and software engineering, and regulatory healthcare data requirements,...HEDISTemporary workApprenticeshipWork at officeRemote work$60k - $71.24k
..., troubleshooting workflow and system-use challenges. Run and interpret clinical, operational, and quality reports, including UDS, HEDIS, and other value-based care metrics Design and evaluate workflow changes that support quality, compliance, and patient outcomes. Employment...HEDISFull timeMonday to Friday- ...safe transitions of care, organizes the practice environment to assure patient safety and quality health outcomes, and contributes to HEDIS and designated quality measures. Location: 5215 Loughboro Rd., Washington, DC 20016 Shift: Full Time (40 hours) - 8:00 a.m. -...HEDISFull timeShift workDay shift
- Description: is intended to describe the general nature and level of work being performed. It is not intended to be an exhaustive list of all responsibilities, duties, and skills required. Management reserves the right to modify, add, or remove duties as necessary. Our...HEDISFull timeTemporary work
$135k - $155k
...preferred ~ Experience managing medically complex or frail elderly populations preferred ~ Familiarity with risk adjustment; HEDIS/STARs measure and care transitions best practices preferred. ~ Demonstrates advanced clinical judgment with strong assessment...HEDISFull timeRemote workMonday to FridayAvail Health
Silver Spring, MD1 day ago- ...management and other clinical quality improvement programs, including Stars and Healthcare Effectiveness Data and Information Set (HEDIS) Quality Improvement Programs, Medication Therapy Management (MTM), interdisciplinary care teams and drug utilization reviews. ~...HEDISFull timeTemporary workWork at officeLocal areaRemote workFlexible hoursWeekend workAfternoon shift2 days per week
CalOptima
Washington DC3 days ago $95k - $105k
...experience in product management or data analytics. Master's degree and 2+ years. Familiarity with FHIR and interoperability standards, HEDIS, and how data and information flows throughout the healthcare ecosystem is critical. Experience writing standards or similar...HEDISFor contractorsWork at office$21.3 per hour
...ROI requested by subpoena to the Quality department for legal review. Document receipt or release of medical records accordingly. HEDIS: Review and respond to HEDIS requests from payors. Performs other duties as assigned; nothing in this job description restricts...HEDISFull timeTemporary workRemote work1 day per week
