HEDIS Analyst jobs

Remote

•

Yesterday

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

Easy Apply

Third Party, Contract

Depends on Experience

Consultant - Payer Services - HEDIS Data Analyst | Architect

Remote or Chicago, Illinois

•

Today

The Opportunity At Huron, we're redefining what a consulting organization can be. We go beyond advice to deliver results that last. We inherit our client's challenges as if they were our own. We help them transform for the future. We advocate. We make a difference. And we intelligently, passionately, relentlessly do great worktogether. Are you the kind of person who stands ready to jump in, roll up your sleeves and transform ideas into action? Then come discover Huron. Whether you have years

Full-time

USD 60.00 - 70.00 per hour

HEDIS Technical Program Manager

Remote

•

15d ago

HEDIS Technical Program Manager Location: Remote Duration : Long Term Job Description We are looking for a Senior Technical Program Manager with HEDIS (Healthcare Effectiveness Data and Information Set) experience to lead our annual HEDIS reporting programs. You will lead complex, cross-functional technical programs spanning data engineering, clinical/quality teams, and compliance from planning through NCQA submission, and you will be the person who keeps the HEDIS reporting cycle

Easy Apply

Contract, Third Party

Depends on Experience

HEDIS Clinical Review Nurse

Columbia, Maryland

•

Today

Candidates MUST BE located in Maryland, Virginia, (or) DC states only! Candidates MUST HAVE an active RN license from Maryland, Virginia, (or) DC states Role: HEDIS Clinical Review Nurse W2 Contract: 5 Months Location: Primarily remote Requires mandatory on-site training in Meriwether, MD, the week of December 14th and occasional travel to provider sites. Pay Rate: $41.49/hour on W2-All inclusive Overview: Work with a leading healthcare organization as a Clinical Medical Review Nurse supporting

Easy Apply

Contract

$40 - $41

Clinical Medical Review Nurse HEDIS Retrospective Project

Columbia, Maryland

•

Today

Company Description Lumen SolutionsGroupInc. is a technology consulting Services company based inFlorida. Weprovidea wide array of experienced business and IT professionals supporting clients from solution design to implementation and support.We specialize in professional IT consulting services, IT Staffing, Business/IT Strategy, Business Process Blueprints, Enterprise Architecture, EnterpriseTransformation. Position: Clinical Medical Review Nurse HEDIS Retrospective Project Locations: Columbi

Easy Apply

Contract

Depends on Experience

Clinical Medical Review RN OR LPN (HEDIS)

Hybrid in Columbia, Maryland

•

Yesterday

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

Easy Apply

Contract

Depends on Experience

Epic Analyst

Remote

•

Yesterday

We're looking for an experienced, US-based Epic professional to support health data exchange work. The focus is provider EMR connectivity: configuring, optimizing, and tracking how provider data flows to the payer. This work supports HEDIS optimization and supplemental data initiatives, with the goal of improving member outcomes and lowering healthcare costs. We're open to candidates at either the Analyst or Manager level.Key ResponsibilitiesSupport project identification, scoping, and provider

Easy Apply

Contract

Depends on Experience

2027 Summer Intern - Data Analytics, HEDIS

Detroit, Michigan

•

Today

Job Description The Internship Program at BCBSM is designed to enhance the skills and abilities of young professionals as well as to identify and attract future talent for our organization. Interns will gain practical hands-on work experience as well as a solid understanding of the health insurance industry. Our program is an excellent way for interns to get a good start on their careers by working on meaningful projects, learning valuable skills, and networking with employees throughout our or

Full-time

Remote Sr. Healthcare QA Tester (HEDIS Preferred)

Remote or Jacksonville, Florida

•

Today

Software Guidance & Assistance, Inc., (SGA), is searching for a Remote Sr. Healthcare QA Tester (HEDIS Preferred) for a 3 month contract assignment with one of our premier healthcare services clients in Jacksonville, FL . (Position will be fully remote) Top Skills Needed: Healthcare QA HEDIS End to end testing Data/SQL validation Senior IT Testing Specialists provide leadership and technical guidance to test teams and has accountability across multiple functions. Creates test deliverables (f

Contract

USD 45.00 - 50.00 per hour

Medical Management Data Analyst

New York, New York

•

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

Hiring! 2 Openings! Sr. Data Engineer with (HEDIS & Healthcare Domain) & Databricks Architect (Enterprise-Scale)

Remote or Texas

•

Today

HIRING 2 DATA ENGINEERING / DATABRICKS POSITIONS We are hiring for 2 positions under one posting. Please review the requirements below and share only relevant profiles. Position 1: Senior Data Engineer Python / PySpark / Databricks Type: C2H Independent Candidates Only Location: Remote Tax Terms: 1099/C2C/W2 Role Overview We are looking for a hands-on engineer who can build tools and engines from the ground up. The role focuses on engine development, data pipeline development, automation,

Easy Apply

Full-time, Contract, Third Party