Average salary: $123,166 /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
- ...standards into actionable tasks and drive improvements in member outcomes through data-driven programs. The role requires deep expertise in HEDIS, NCQA and URAC, proven cross-functional leadership, and the ability to manage #J-18808-Ljbffr Blue Cross Blue Shield AssociationHEDIS
- ...Computer SciencePreferred Qualifications• Master of Science in Mathematics, Engineering, or Computer Science• Working knowledge of HEDIS, Fraud, Waste & Abuse• Working knowledge of ETL• Working knowledge of ALMAdditional InformationContact Me:Jai(***) ***-****SummaryType...HEDIS
- ...healthcare providers and aligning agreements with regulatory standards. The candidate will negotiate contracts, manage provider relationships, and support network growth while ensuring compliance and aligning with HEDIS, CAHPS, NCQA, and #J-18808-Ljbffr Enlightened, Inc.HEDISFor contractorsWork at officeRemote work
- Grace at Home in Washington, DC is seeking a Manager of HEDIS, Stars & ACO Data Analytics to lead measurement and reporting across product lines, ensuring regulatory compliance and audit readiness. You will drive quality performance improvement, data integration, and vendor...HEDIS
- ...facilitates safe transitions of care, organizes practice environment to assure patient safety and quality outcomes, and contributes to HEDIS and designated quality measures.Location: 4102 Wilson Blvd., Arlington, Virginia 22203Shift: Non-exempt. - Full-time 40 hours per...HEDISFull timeLocal area
Johns Hopkins Medicine
Arlington, VA14 hours ago - ...initiatives to improve affordability and/or safety Quality - initiatives to improve patient care and organizational performance on HEDIS and CMS 5-Star measuresEssential Responsibilities:Support statewide clinical pharmacy services in partnership with key stakeholders...HEDISWork at officeLocal areaRemote workFlexible hours
- ...education and training for CLIENT providers on applicable processes procedures. Develop strategies along with our PBM partners to improve HEDIS ratings and other quality measures. Participate in onsite visits to hospital systems and selected physician group practices and...HEDISLocal area
Careers Integrated Resources Inc
Washington DC5 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 work
Careers Integrated Resources Inc
Washington DC5 days ago - ...specifications.Partner with Reporting/BI teams to validate data extracts and metric definitions.Ensure eCW configuration to support UDS, HEDIS, PCMH, and other quality programs.Monitor data integrity and ensure compliance with HIPAA and regulatory requirements.Training &...HEDISImmediate start
- ...facilitates safe transitions of care, organizes practice environment to assure patient safety and quality outcomes, and contributes to HEDIS and designated quality measures. Location : 4102 Wilson Blvd., Arlington, Virginia 22203 Shift : Non-exempt. -...HEDISFull timeLocal areaShift work
Johns Hopkins HealthCare
Arlington, VA3 days ago $109.5k - $164k
...overall quality of care, and increasing patient satisfaction in the healthcare systemDocument timely with an added focus on closing HEDIS quality gap measures and recapturing HCCsEngage new patients enrolling in the program with a comprehensive geriatric focused initial...HEDISMinimum wageFull timeTemporary workWork experience placementLocal areaRelocation packageNight shift- ...management teams, community-based healthcare providers, and community organizations. Inform members of the actions required to meet HEDIS, EPSDT, health plan requirements, and other outreach initiatives through phone calls and home visits, while encouraging compliance....HEDISFull timeWork experience placementWork at officeLocal areaFlexible hours
Enlightened
Washington DC5 days ago - ...Quality and Clinical Outcomes:Define customer and member expectations in order to influence programs to improve clinical quality metrics (HEDIS, CAHPS), ensuring integrated care delivery aligns with members needs and organizational goals.Partner with risk adjustment teams to...HEDISWork at officeLocal areaImmediate start
$198.18k - $278.05k
...lists and gap closure data are delivered to Plans• Facilitate consultative support for Plans on evidence-based interventions to improve HEDIS, administrative, and Part D Stars measures• Coordinate with BHI on Stars benchmarking and tracking Annual Wellness Visit and...HEDISFull timeContract workWork at officeLocal areaShift work- ...thresholds. Oversee the performance of Value-Based Care & Population Health and Quality teams. Support ACO, Medicare Advantage, MSSP, HEDIS, Star Ratings, and other risk-based contract strategies as applicable. Provider Leadership, Performance and Workforce Development...HEDISContract workLive inRelocation
CloseKnit
Alexandria, VA7 days ago - ...Creative and Community-Minded. The Nurse Practitioner will have a strong knowledge base in providing care in the home, Value Based Care, HEDIS and Stars, documentation and coding, and medical practice principles. They will stay informed about advancements in healthcare...HEDISTemporary workLive inWork at officeLocal areaRemote work
CINQCARE
Laurel, MD2 days ago $99k - $232k
...consulting or advisory firm experience preferred Contributing to commercial analytics product development Familiarity with NCQA HEDIS specifications and CMS Star Ratings Knowledge of government payer programs and Medicaid Experience with NLP or unstructured...HEDISH1bPwC
Washington DC5 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 DC6 days ago $40 - $43 per hour
...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...HEDISFull timeCasual workWork at officeLocal areaImmediate startRemote workRelocation packageShift workWeekend work$15k
...transferring of patients to emergency facility and arrange for hospitalization as needed 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 workRelocation packageAfternoon shiftMary's Center
Silver Spring, MD2 days ago- ...departments. Provides direction and leadership for the department and manages day-to-day and emerging needs/issues. Keeps current of HEDIS, NCQA, URAC requirements, and translates new standards and measurement requirements to FEP and Plan responsibility tasks. Sets the...HEDISWork experience placementWork at officeShift work
$68.7k - $92.7k
...healthcare quality, population health, clinical operations, disease management, or performance improvement experience Knowledge of HEDIS quality measures 6+ months of driving improvement of HEDIS quality measures experience Knowledge of preventive care guidelines and healthcare...HEDISLocal areaFlexible hoursAmazon
Arlington, VA14 hours 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 with...HEDISHourly payFull timeWork experience placementWork at officeFlexible hoursShift work- Job Description Summary This position supports and executes the Healthcare Effectiveness Data and Information Set (HEDIS) data quality strategy for optimal HEDIS submission to National Committee for Quality Assurance (NCQA). Responsibilities include oversight of the HEDIS...HEDISShift work
- ...value-based care organizations are where the financial stakes are highest. Member services contact centers, care management outreach, HEDIS and STAR gap closure, and post-discharge follow-up represent hundreds of millions of dollars of annual operating cost in every...HEDISRemote job
- ...by state) Frequently review Quality metrics, pod level performance and identify areas for improvement leading to superior Quality (HEDIS) performance Frequently review clinician capacity and productivity performance. Partner with Site Medical Directors to develop...HEDISWork at officeWeekend work
HarmonyCares
Springfield, VA10 hours ago $90k - $110k
...~ Design and implement workflows to achieve quality outcomes, partnering with internal teams to build process documentation for HEDIS measures. ~ Manage payer relationships and collaborate with external payer teams to drive clinical quality outcome strategies....HEDISFull timeContract workWork experience placementWork at officeLocal areaRemote workWork from homeHome officePrivia Health
Arlington, VA12 days ago$92.8k - $126.4k
...and state laws, regulations, policies, and internal procedures. Support quality initiatives by negotiating contracts aligned with HEDIS, CAHPS, NCQA, and URAC standards. Negotiate contracts that promote provider satisfaction and long-term network stability. Collaborate...HEDISFull timeContract workFor contractorsWork at officeLocal areaRemote workFlexible hours1 day per week- ...to make health and care a reality—not a burden—every single day. Join us in creating a better way to care. Overview The Manager of HEDIS, Stars & ACO Data Analytics leads all aspects of HEDIS, Medicare Stars, and ACO quality measurement and reporting across product lines...HEDISContract workTemporary workLive inWork at officeLocal area
