Average salary: $56,476 /yearly
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- ...Mercyhealth is seeking an experienced Registered Nurse Case Manager to coordinate individualized care plans and ensure compliance with NCQA, HEDIS, and quality standards. This full-time, day-shift role requires strong care coordination and a commitment to improving member...HEDISFull timeDay shift
Mercy Health System
Janesville, WI4 days ago - ...Healthcare seeks a Quality Management professional to oversee and implement health plan quality improvement activities, ensuring NCQA/HEDIS compliance and regulatory reporting. You will support accreditation surveys and governance across departments. Responsibilities...HEDIS
Molina Talent Acquisition
Milwaukee, WI3 days ago - ...Committee. The Pharmacist collaborates with other NHP departments to optimize regulatory compliance and Quality Measures such as NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and provider detailing. Location: Candidates must...HEDISWork at officeWork from homeHome officeMonday to Friday
Network Health
Menasha, WI2 days ago - ...care to the member Work collaboratively with the Quality Department and CMO to provide feedback and improve outcomes related to HEDIS, Performance Improvement Projects (PIPs) and NCQA projects. Minimum Requirements of the Position ~ Associate degree required in...HEDISFull timeWork at office
Group Health Cooperative of Eau Claire
Altoona, WI3 days ago $128.69k - $183.84k
...adherence, and managing chronic diseases to improve patient outcomes and elevate quality performance metrics such as CMS Star Ratings and HEDIS scores. The manager partners closely with patients, physicians, advanced practice providers, nurses, and care teams to deliver...HEDISHourly payFull timeLocal areaFlexible hoursWeekend workAfternoon shift3 days per weekChenMed
Milwaukee, WI1 day ago$120 per hour
...company 401(k) plan at a 3 % contribution rate with the option to opt out. Responsibilities Knowledge of CMS Regulations and NCQA HEDIS Guidelines; Knowledge of Evidence-based Clinical Practice Standards: American Diabetes Association (ADA), American College of...HEDISDaily paidLocal areaComplexCare Solutions
West Bend, WI1 day ago$93k - $116.2k
...PowerPointDeep understanding of outcomes-based work, metrics, and reporting dashboardsUnderstanding of CMS regulations and submissions (HEDIS, STAR, EDGE)Experience working with external vendors including negotiation skillsCertification in one of the following: PMP, PMI-ACP...HEDISFull timeWork at officeWork from homeQuartz Health Solutions
Madison, WI5 days ago- ...acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description About the Job: We are currently recruiting RNs,...HEDISPermanent employmentFull timeLive inWork from home
Altegra Health
Milwaukee, WI1 day ago - ...-based care models. Experience working in a start up environment. Familiarity with common quality reporting frameworks (e.g., HEDIS, MIPS, OCM measures). Experience using PowerBI and Tableau healthcare dashboards. Benefits: Integra Connect, LLC provides...HEDIS
Integra Connect LLC
Milwaukee, WI5 hours agonew - ...medical guidelines, indicators for staying healthy, not limited to screenings, tests, and vaccines, managing chronic conditions and all HEDIS indicators. Monitors primary medical group compliance with performance measures and implements strategies within the group for...HEDIS
- ...standards pertaining to appropriate patient needs. Focuses clinical care delivery to support necessary items for documentation/coding, HEDIS measures, engagement of patients, and managing medical expenses. Serves as a key resource for patients in delivering ongoing care...HEDISWork at office
$110.47k - $237.93k
...opportunities. Identifies strategies and implements timely and effective action plans to maintain clinical excellence at all times. (e.g., HEDIS, NPS, RVUs, etc.) Understand, articulate, and ensure compliance with State Provider Practice Acts, State Board regulations,...HEDISHourly payFull timeTemporary workWork experience placementWork at officeLocal areaWork from home3 days per week2125 MinuteClinic, L.L.C.
Wausau, WI3 days ago$66.46k - $129.59k
...and the plan. Develops and implements strategies to increase provider engagement in Healthcare Effectiveness Data Information Set (HEDIS) and quality initiatives. Engages contracted network providers regarding cost control initiatives, medical cost ratio (MCR), non-...HEDISContract workWork experience placementWork at officeMolina Healthcare
Milwaukee, WI4 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 officeFlexible hoursShift workChenMed
Oregon, WI1 day ago$78.8k - $177.68k
...applications (e.g., cost of care, quality measurement, utilization management). Familiarity with key industry metrics and frameworks, such as HEDIS, population health, risk adjustment, and value-based payment models. Prior experience in a consulting firm, health plan, or health...HEDISFull timeWork experience placementRemote workFlexible hoursMilliman
Brookfield, WI7 days ago- ...ExperiencePrevious health plan experienceBilingual (English/Spanish) preferredCertification in Care Management or related specialtyKnowledge of HEDIS and Stars measuresWork ScheduleMonday through Friday, 8:00 AM – 5:00 PM local time– This position does not require holidays, on-call...HEDISTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome office
Humana
Racine, WI2 hours agonew $66.58k - $142.58k
..., and evaluation of POSC Council workplans. Supports POSC Council and executive sponsors to advance initiatives aimed to achieve HEDIS and CAHPS goals. Provides insights and recommendations to optimize healthcare practices and achieve highest standards of care and service...HEDISHourly payFull timeTemporary workWork experience placementLocal areaWork from homeMonday to Friday$106.52k - $157.27k
...expertise required will vary based on the specific opening, but include the following: Medical expense and trends Quality including HEDIS reporting, interventions, and STAR ratings Clinical gaps and adherence Network Management contracting and pay-for-performance/value-...HEDISFull timeTemporary workRemote workShift work$110.95k - $163.2k
...experience with other Epic modules such as EpicCare Ambulatory, Reporting Workbench, SlicerDicer, Familiarity with CMS quality programs, HEDIS measures, and risk adjustment. Knowledge of SQL or other data query languages. Education ~5+ years of relevant experience...HEDISFull timeTemporary workRemote workShift work$62.7k
...prospective, semi-annual, and annual audits, identify gaps and communicate results. Conduct continuing education to providers on STARS, HEDIS, and HCC Coding. Conduct re-audits as needed Other duties as assigned or requested. EDUCATION Required ~ Current state RN...HEDISFor contractorsWork at officeLocal areaRemote work$106.52k - $157.27k
...including payer functions, ambulatory, acute & post-acute care and support functions. Medical expense and trends Quality including HEDIS reporting, interventions, and STAR ratings Network Management contracting and pay-for-performance/value-based measures State and Federal...HEDISFull timeTemporary workRemote workShift work$35 - $40 per hour
...a new Stars measure and confirming successful emergency department discharge. Additional responsibilities may include closing other HEDIS measures, all while delivering compassionate, high-quality virtual care. Schedule: Monday to Friday - 1230pm to 9pm & one Saturday...HEDISFull timeTemporary workWork experience placementRemote workVisa sponsorshipWork visaMonday to FridayFlexible hours$300k
...00–$290,000 (negotiable) Bonus Structure: Up to 20% of base salary Based on attainable quality and satisfaction metrics (HEDIS, outcomes, etc.) Ongoing support from senior clinical leadership to help you meet targets ~ Sign-On Bonus: Up to $60K ~...HEDISRelocation package$90.5k - $155.2k
...Analyst is responsible for delivering analytics and insights that support Medica’s Quality Strategy, including performance across STARS, HEDIS, NCQA, and regulatory quality programs. This role translates healthcare, clinical, and claims data into actionable insights that...HEDISWork experience placementWork at office3 days per week
