Senior Manager – Quality (HEDIS)

Job Description: Crop to Crop resumes are accepted Sample Role Types: Technical Specialist, Product Specialist, System Specialist, Security Analyst This position provides expert-level support of clinical terminology standards and complex mapping activities across the HIE. The specialist resolves high-impact data quality issues, interprets evolving coding requirements, and implements best practices for semantic interoperability. Given that the terminology services tool requires extensive manual t

Functional Description: This role requires significant expertise of Medicaid Enterprise System modules and data warehouse or decision support systems. This role provides input and direction supporting a large data warehouse implementation and operations. The selected SME will provide direction to business and technical team members related to claims, provider, and recipient data. Roles in this function could partner with stakeholders to understand data requirements and support development tool

Overview The QA Lead for Computer-Assisted Coding (CAC) and Clinical Documentation Integrity (CDI) Software Deployment is responsible for defining, governing, and executing the quality assurance strategy for enterprise CAC/CDI implementations across inpatient, outpatient, and professional billing environments. This role ensures that system functionality, integrations, workflows, and outputs meet documented business requirements, regulatory expectations, and operational performance standards both

RESPONSIBILITIES: Kforce has a client in Pinellas Park, FL that is seeking an Integration Specialist to lead and support healthcare data integrations between hospital EMR systems and our internal systems. These integrations power our physician advisory services, enabling clinical, utilization management, and revenue cycle insights that directly impact hospital financial outcomes. This role is ideal for someone who has worked hands-on with Epic and Cerner, understands HL7-based and FHIR data exch