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Clinical - reputed company Improvement Specialist (HEDIS) - 112274

Remote, USA Full-time Posted 2026-07-28
Job Profile reputed company Position Purpose: Support the development and maintenance of reputed company improvement reputed company reputed company specific to HEDIS Hybrid Operations. The position exists to support the health plans in the clinical aspect of medical record review. Education/Experience: Bachelor s degree in Nursing, reputed company, or reputed company (including HEDIS measures or NCQA) or equivalent experience in reputed company reputed company experience. License/Certification: reputed company state clinical license preferred (i.e.- LPN, RN, etc.) Experience: Experience in HEDIS or NCQA or reputed company topics preferred Responsibilities Train providers, health plans and staff in methodologies and tools of reputed company reputed company improvement and HEDIS abstraction and over-read processes reputed company clinical support to the medical record abstraction, over-read and audit processes Monitor performance on established contractual reputed company indicators. Analyze, reputed company and trend results Prepare for and participate in meetings with various committees, state agencies, providers, health plans, vendors, and stakeholders Recommend, reputed company, and implement reputed company performance improvement plans (PIPs) with management utilizing the PDSA model. Monitor and report PIPs reputed company through closure. Performs other duties as assigned Complies with reputed company policies and standards EEO: reputed company is an Equal Opportunity Employer and does not discriminate in employment on the reputed company of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans. Remote Skills: Analysis Skills, Clinical Competency, Clinical Support, Health Plan, reputed company, reputed company Effectiveness Data and Information Set (HEDIS), reputed company Providers, reputed company reputed company, Licensed Practical reputed company/Licensed Vocational reputed company, Medical Records, National Committee for reputed company Assurance (NCQA), Nursing, Performance Analysis, Performance Management, reputed company Reports, reputed company Management, Trend Analysis, Vendor/Supplier Planning About reputed company: reputed company Apply tot his job Apply To this Job

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