HEDIS Analyst jobs

Remote

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29d ago

Hi Professionals, Title: HEDIS Analyst/Consultant Locattion: Remote JD: Must-Have: US Healthcare Payer Actuarial Underwriting HEDIS / Quality Claims & Enrollment Data PMPM / MLR / IBNR / Risk Adjustment SQL & Data Profiling Data Lineage / Data Mapping Business Rule Discovery Reverse Engineering Healthcare Analytics / Data Modernization Snowflake (Preferred) Key Requirements: Strong US Healthcare Payer domain expertise Experience with Actuarial, Underwriting & HEDIS/Quality Knowle

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Contract, Third Party

Depends on Experience

Clinical Medical Review RN OR LPN (HEDIS)

Hybrid in Columbia, Maryland

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8d ago

The Clinical Medical Review Specialist (a professional with clinical experience) will report to the Clinical Support Supervisor HEDIS and be part of the Quality Team. The main duties include chart retrieval, using proprietary tools and software to conduct thorough medical record reviews in line with NCQA specifications, retrieval follow-up, and escalating issues as needed. Main duties will be assigned according to experience, knowledge, skills, and abilities. This role requires extensive knowled

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Contract

Depends on Experience

Medical Management Data Analyst

New York, New York

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Today

Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. About NYC Health + Hospitals MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of produc

Full-time

USD 70,000.00 - 80,000.00 per year