HEDIS jobs in California

Remote

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21d 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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Third Party, Contract

Depends on Experience

Clinical Medical Review Nurse

Remote

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23d ago

Clinical Medical ReviewNurse (HEDIS Medical RecordsRetrieving) Columbia, MD (Primarily remote, but hybrid) 6 Months+ PURPOSE: Seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a payer, health insurance, or HEDIS vendor environment. The ideal candidate will understand NCQA healthcare quality metrics and have a proven ability to accurately abstract, interpret, and document medical record data for HEDIS gap closure. This role will support me

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Contract, Third Party

Depends on Experience

Data Analyst III

Remote or Florida

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Today

Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, work Eastern or Central Time Zone business hours. Knowledge of writing SQL

Full-time

Clinical Data Audit Consultant

Remote or California

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Today

Position Purpose: The Clinical Data and Audit Consultant is responsible for the clinical content component of all data collection, account implementations, and audit activities for Clinical Operations to ensure high-quality tracking and performance of the service teams. Key Details: Registered Nurse - Must be currently licensed in CA. Pacific Time Zone Work Hours The Consultant gathers and analyzes data, creates workflows, coordinates internal and external audits, and analyzes and documents bu

Full-time

USD 33.71 - 60.67 per hour

Healthcare Data Engineer

Remote

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Today

Data Engineer - Healthcare Analytics Remote This is a Remote role. Compensation: $65 - $85 per hour Contract Length: Up to 12 months Hours: 8am-5pm MST, M-F Start Date: ASAP, 10/5/2026 ABOUT THE ROLE Join a mission-driven healthcare analytics team supporting a nonprofit health insurance provider serving over 1 million members across the Mountain West region. As a Data Engineer, you will play a key role in building the data foundation for value-based care initiatives, including risk adjustment,

Contract

$65.00 - $85.00

Associate Director - QOI Supplemental Data Operations - Remote CST or EST

Remote or Minnetonka, Minnesota

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Today

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together. The Associate Director,

Full-time

USD 112,700.00 - 193,200.00 per year

Senior Data Engineer - Remote

Remote or Eden Prairie, Minnesota

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Today

Optum Tech is a global leader in health care innovation. Our teams develop cutting-edge solutions that help people live healthier lives and help make the health system work better for everyone. From advanced data analytics and AI to cybersecurity, we use innovative approaches to solve some of health care's most complex challenges. Your contributions here have the potential to change lives. Ready to build the next breakthrough? Join us to start Caring. Connecting. Growing together. The Optum Hea

Full-time

USD 91,700.00 - 163,700.00 per year

Engineer I - Integrated Operations

Rancho Cucamonga, California

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Today

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Reporting to the Supervisor, Integrated Operations, the Engineer I - Integrated Operations is a technical operations role responsible for real time monitoring, alert response, and first level triage across IEHP's Windows and Linux server environments, Cisco network environment, and application

Full-time

USD 91,249.60 - 120,910.40 per year

Principal Data Architect & Advisor

Remote

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Today

Principal Data Architect & Advisor Remote Newtown Square - Mostly remote but will need to come in 1 day a month to Newtown Square- someone who is going to be able to drive (PA, NJ, DE, VA, MD, NY, CT, etc) 12+ month Contract Client Domain - Major Medicare/Medicaid Healthcare Insurance company Newtown Square PA. must be 100% great communication. No exceptions. High level communicator. Our client in Greater Philadelphia area is seeking a Principal Data Architect & Advisor to provide senior, hand

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Contract

70 - 75

Developer I - BI & Analytics

Rancho Cucamonga, California

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Today

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Under the direction of the Supervisor, Bi & Analytics, the Developer I - Bi & Analytics is responsible for creating, maintaining and updating IEHP enterprise reports and dashboard. The position also serves as the technical support for all reporting projects within the Bi & Analytics team. The

Full-time

USD 91,249.60 - 120,910.40 per year

Senior Engineer, Big Data - Medical Cost Grouper - Remote

Remote

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Today

Job Description JOB DESCRIPTION Job Summary Provides senior level engineering support for information technology (IT) big data architecture activities on Microsoft Azure cloud infrastructure. Representing as a Forward Deployed Engineer, responsible for collecting, storing, processing, and analyzing large health care payor datasets supporting Medicare/Medicaid operations. Designs and builds data solutions on Azure Databricks, Azure Data Factory, and Azure Synapse with emphasis on performance, sc

Full-time

USD 79,607.91 - 172,483.80 per year

Engineer III - Security Analyst

Rancho Cucamonga, California

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Today

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Reporting to the Manager, Information Security Operations, the Engineer - Security Analyst services as a senior cybersecurity practitioner and consultant, advancing the organization's defensive posture across on-premises and cloud environments. This position maintains and improves security po

Full-time

USD 135,200.00 - 179,129.60 per year

IT Specialist II - Service Desk

Rancho Cucamonga, California

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Today

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Reporting directly to IT Workplace Services leadership, the IT Specialist II - Service Desk is a position that encapsulates the IT Specialist I role and is responsible for advanced remote technical support and operational guidance within the IT Infrastructure Services department. This role exe

Full-time

USD 71,572.80 - 93,038.40 per year

Applied AI Scientist IV - Healthcare, LLM/SLM, RAG experience

Remote or Dayton, Ohio

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Today

Job Summary: The Applied AI Scientist IV is responsible for establishing technical direction and leading the design, development, and operationalization of advanced artificial intelligence solutions that improve healthcare operations, patient outcomes, and organizational performance. This role provides enterprise-wide technical leadership across machine learning, Generative AI, Agentic AI, Retrieval-Augmented Generation (RAG), and Natural Language Processing (NLP) initiatives. The Applied AI Sc

Full-time

USD 113,000.00 - 197,700.00 per year

IT Service Desk Shift Lead

Rancho Cucamonga, California

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Today

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Reporting to the Supervisor, IT Service Desk, the IT Service Desk Shift Lead is a critical operational lead within the IT Workplace Services team. This position is responsible for ensuring the delivery of reliable, exemplary Tier 1-3 support across the enterprise. This role stewards the day to

Full-time

USD 91,249.60 - 120,910.40 per year

Director of Engineering, Data Products

Remote

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Today

At Counterpart Health, we are transforming healthcare and improving patient care with our innovative primary care tool, Counterpart Assistant. By supporting Primary Care Physicians (PCPs), we are able to deliver improved outcomes to our patients at a lower cost through early diagnosis and longitudinal care management of chronic conditions. We're looking for a Director of Engineering to lead our Data Products pillar, serving as the technical engine for Counterpart Health's (CPH) clinical-data fo

Full-time

USD 223,100.00 - 290,000.00 per year

Epic Analyst (Healthy Planet) remote

Remote

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16d ago

Epic Analyst (Healthy Planet) REMOTE LONG Term Contract 2 Virtual round 10+ years of experience This position requires the analyst to have a Healthy Planet from Epic and ideally: Experience with Compass Rose / advanced risk stratification tools Experience integrating external data sources (claims, SDOH, HIE feeds) into Healthy Planet models Strong background in quality measure logic (HEDIS, eCQMs) Familiarity with care management documentation and utilization workflows Sameeksha Singh | Del

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Contract

Depends on Experience

Principal Data Architect

Remote

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2d ago

Position Description Assess data functions for maturity, delivery health, gaps, overlaps, and handoff issues, and recommend practical improvements.Advise Data team leaders on architecture, engineering, governance, quality, delivery, cost, and risk, and track recommendations through results.Review and challenge solution designs, data models, architecture decisions, and engineering approaches before build.Ensure adherence to Azure Databricks lakehouse, ADF, and medallion architecture standards, in

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Contract

Depends on Experience

Manager, Data Science

Rancho Cucamonga, California

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Today

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! The Manager, Data Science leads a team of data scientists, ML engineers, and AI specialists. This role requires a strong balance of technical expertise in advanced machine learning (including Generative AI), leadership experience, health care domain knowledge preferably in the managed care spa

Full-time

USD 154,128.00 - 204,214.40 per year

Senior UiPath Developer Healthcare Payer Automation

Remote

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Today

Senior UiPath Developer Healthcare Payer Automation Remote / EST work hours Tentative duration - 6 months + There are 2 roles, 1 Senior UiPath Developer, and other Mid level UiPath Developer Required Technical Skills UiPath Studio and/or Studio Web; UiPath Orchestrator. UiPath queues, assets, schedules/triggers, unattended robots, package/version management and environment promotion. REFramework or comparable enterprise automation framework. Exception handling, structured logging, retry/reco

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Contract, Third Party

HEDIS jobs in California, USA