Hedis jobs in new york, ny

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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24d 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

Clinical Informatics Expertise

Remote

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Today

Title:Clinical Informatics Expertise Location:Remote Length:Long termRestriction:w2 or c2cDescription:Interview Type: Webcam Interview Only Very long term project; initial PO for 1 year, expect to go for 4+ years Remote Job DescriptionIdeal Candidate RequirementsThe ideal candidate will have: A strong understanding of clinical documentation, EHR systems, and data interoperabilityExperience working with clinical coding systems such as SNOMED CT, LOINC, ICD, CPT, and RxNormExperience with quality

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Contract

Depends on Experience

Clinical Informaticist

Remote

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Today

The Clinical Informaticist acts as a Subject Matter Expert (SME) in clinical data and quality measurement, providing critical support to clinical evaluators, product teams, and data validation initiatives.The ideal candidate will have A strong understanding of clinical documentation, EHR systems, and data interoperability Experience working with clinical coding systems such as SNOMED CT, LOINC, ICD, CPT, and RxNorm Experience with quality measurement programs and tools (e.g., HEDIS, eCQMs, dQM)

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Contract

Depends on Experience

Clinical Informaticist

Remote

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Today

The Clinical Informaticist acts as a Subject Matter Expert (SME) in clinical data and quality measurement, providing critical support to clinical evaluators, product teams, and data validation initiatives. Duties include but are not limited to: Serve as a clinical SME for NC HealthConnex solution teams, providing insights on clinical concepts and data use cases.Data Aggregator Validation ProgramSupport clinical evaluators with interpretation and validation of clinical resources and content.Provi

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Contract, Third Party

Depends on Experience

Clinical Informatics Data Analyst

Remote

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Today

Position: Clinical Informaticist Location: Raleigh, NC Work Arrangement: Remote Interview Process: Webcam Interview Only Position Overview We are seeking a Clinical Informaticist to serve as a Subject Matter Expert (SME) in clinical data and quality measurement. In this role, you will bridge the gap between clinical and technical domains, supporting data validation, quality measurement programs, and health data interoperability. Key Skills & Qualifications < data-path-to-node="11">Primary (Req

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Contract, Third Party

Depends on Experience

Clinical Informaticist

Remote

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Today

The Clinical Informaticist acts as a Subject Matter Expert (SME) in clinical data and quality measurement, providing critical support to clinical evaluators, product teams, and data validation initiatives. The ideal candidate will have: A strong understanding of clinical documentation, EHR systems, and data interoperability Experience working with clinical coding systems such as SNOMED CT, LOINC, ICD, CPT, and RxNorm Experience with quality measurement programs and tools (e.g., HEDIS, eCQMs,

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Contract

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

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

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

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

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

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

Epic Analyst (Healthy Planet) remote

Remote

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17d 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

Clinical Informaticist - 100% Remote

Remote

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Today

The Clinical Informaticist acts as a Subject Matter Expert (SME) in clinical data and quality measurement, providing critical support to clinical evaluators, product teams, and data validation initiatives. The ideal candidate will have: A strong understanding of clinical documentation, EHR systems, and data interoperabilityExperience working with clinical coding systems such as SNOMED CT, LOINC, ICD, CPT, and RxNormExperience with quality measurement programs and tools (e.g., HEDIS, eCQMs, dQM)A

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Contract, Third Party

Depends on Experience

Clinical Informatics Subject Matter Expert - REMOTE

Remote

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Today

Job Description: Crop to Crop resumes are accepted The Clinical Informaticist acts as a Subject Matter Expert (SME) in clinical data and quality measurement, providing critical support to clinical evaluators, product teams, and data validation initiatives. The ideal candidate will have: A strong understanding of clinical documentation, EHR systems, and data interoperability Experience working with clinical coding systems such as SNOMED CT, LOINC, ICD, CPT, and RxNorm Experience with quality m

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Contract, Third Party

Depends on Experience

Principal Data Architect

Remote

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3d 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

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 New York, NY, USA