Top 50 Hedis Jobs in Ohio

Sr Quality Improvement/HEDIS Spec, Health Plan Interventions (Remote In Ohio)
Molina Healthcare —Cleveland, OH
- $54,922 - $107,099 a year
- Full-time
- Remote
- RN License
- Writing skills
- Analysis skills
- Health insurance
Sr Quality Improvement, HEDIS Spec, Health Plan Interventions (Remote In Ohio)
Molina Healthcare, Inc. —Cincinnati, OH
- $54,922 - $107,099 a year
- Full-time
- Remote
- RN License
- Writing skills
- Analysis skills
- Health insurance
Director HEDIS & Quality Improvement Analytics
Medical Mutual of Ohio —Cleveland, OH
- Hybrid work
- System design
- Office
- Master's degree
- Health savings account
- Disability insurance
Advanced Practice Provider
LiveWell Choice, LLC —Ashtabula, OH
- Full-time
- Nursing
- Clean driving record
- Skilled nursing facility
Quick Apply
4d
Advanced Practice Provider
LiveWell Choice, LLC —Millersburg, OH
- Full-time
- Nursing
- Clean driving record
- Skilled nursing facility
Quick Apply
4d
Physician Leader Youngstown Ohio
HarmonyCares —Youngstown, OH
- Full-time
- CPR Certification
- Clean driving record
- Medicine
- Paid training
- Paid holidays
Physician Leader Cleveland Ohio
HarmonyCares —Middleburg Heights, OH
- Full-time
- CPR Certification
- Clean driving record
- Medicine
- Paid training
- Paid holidays
22h
Physician Leader- Akron Ohio
HarmonyCares —Uniontown, OH
- Full-time
- CPR Certification
- Clean driving record
- Medicine
- Paid training
- Paid holidays
22h
Clinical Quality Improvement Nurse
Medical Mutual of Ohio —Cleveland, OH
- Hybrid work
- Nursing
- Microsoft Excel
- RN License
- Health savings account
- Disability insurance
5d
Health Plan Care Manager (RN or LSW)
CommuniCare Advantage —Cincinnati, OH
- Full-time
- Nursing
- RN License
- Mid-level
Quick Apply
Director, Data Analytics; Quality and Info Analytics;670
The Centers —Cleveland, OH
- $88,500 - $102,500 a year
- Full-time
- 5 years
- Writing skills
- Master's degree
Quick Apply
Community Based Quality Advanced Practice Provider
ABC Health —Columbus, OH
- $150,000 - $160,000 a year
- Full-time
- Mid-level
- Driver's License
- Travel
- Mileage reimbursement
- Health insurance
Quick Apply
Senior Director, Market Performance
Cityblock Health —Ohio
- $153,000 - $210,000 a year
- Full-time
- 11+ years
- Master's degree
- Bachelor's degree
- Health insurance
- Paid time off
Manager, Behavioral Health Clinical Liaison/Operations
Amerihealth Caritas —Dublin, OH
- Full-time
- LMFT
- RN License
- Mid-level
- Health insurance
Manager, TCHP Practice - Mason Internal Medicine - Full Time - Days
The Christ Hospital Health Network —Mason, OH
- Full-time
- Microsoft Excel
- Microsoft Outlook
- OSHA
CareConnect Registered Nurse (RN) – In home Urgent Care - Cincinnati, Ohio
Wellbe Senior Medical —Cincinnati, OH
- $77,000 - $112,000 a year
- Full-time
- CPR Certification
- Google Workspace
- Clean driving record
RN Care Manager - Cleveland Market
ArchWell Health —Cleveland, OH
- Full-time
- Nursing
- RN License
- Mid-level
CareConnect Registered Nurse (RN) – In home Urgent Care - Brecksville, Ohio
Wellbe Senior Medical —Brecksville, OH
- $77,000 - $112,000 a year
- Full-time
- CPR Certification
- Google Workspace
- Clean driving record
CareConnect Registered Nurse (RN) – In home Urgent Care - Toledo, Ohio
Wellbe Senior Medical —Toledo, OH
- $77,000 - $112,000 a year
- Full-time
- CPR Certification
- Google Workspace
- Clean driving record
CareConnect Registered Nurse (RN) – In home Urgent Care - Dayton, Ohio
Wellbe Senior Medical —Dayton, OH
- $77,000 - $112,000 a year
- Full-time
- CPR Certification
- Google Workspace
- Clean driving record

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Sr Quality Improvement/HEDIS Spec, Health Plan Interventions (Remote In Ohio)

Molina Healthcare -
Cleveland, OH

Apply Now

Job Details

Full-time
$54,922 - $107,099 a year

Benefits

Health insurance

Qualifications

Managed care
Managed care organization experience
Writing skills
Clinical program data analysis
Productivity software
Clinical data analysis

Full Job Description

Molina Healthcare of Ohio is hiring for a Sr Quality Improvement/HEDIS Specialist on our Health Plan Community Interventions team.
This role is remote however candidates must live in Ohio.

This role is laser focused on Quality Improvement using QI Science. This role will be assigned a primary population stream and will be expected to support improvement work for Medicare Stars Measures.

Highly qualified candidates will have the following experience-

Using the specific models for improvement required by the state of Ohio
Experience with a formal model like IHI or Lean or Six Sigma, Green or Yellow Belt Improvement
Power BI is helpful but expert level is not required
Familiarity with Medicare (Ideally the Duals population)
Familiarity with QI Science, Health Equity, Population Health, Health Management

This role also provides senior level support for clinical quality member intervention activities. Responsible for the developing and implementing new and existing member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid, etc.). Executes health plan member and community quality-focused interventions and programs in accordance with established program standards, and federal/state/National Committee for Quality Assurance (NCQA) regulations. Conducts data collection, monitors intervention activity including key performance measurement activities, reports intervention outcomes, and supports continuous improvement of intervention processes and outcomes.

Essential Job Duties

Implements evidence-based and data-informed key member intervention strategies including initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state quality initiatives.
Monitors and ensures that key member intervention activities are completed on time and accurately, and presents results to key departmental management and other applicable Molina departments.
Writes narrative reports to interpret regulatory specifications, explains programs and results of programs, and documents findings and limitations of department interventions.
Creates, manages, and/or compiles required documentation necessary to maintain critical program milestones, deadlines, and deliverables.
Participates in quality improvement (QI) activities, meetings, and discussions with and between other departments within the organization.
Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based organizations (CBOs).
Evaluates quality project/program activities and results to identify opportunities for improvement.
Raises gaps in processes that may require remediation to quality leadership.
Provides support for quality-related projects.
Provides training and support to new and existing quality member interventions team members.
Demonstrates flexibility when it comes to change management and maintains a positive outlook.
This position may require same day out of office travel 0 - 80% of the time, depending upon state-specific needs.
This position may require multi-day overnight travel on occasion, depending upon state-specific needs.

Required Qualifications

At least 3 years of experience in health care, and at least 2 years of experience in health plan quality member interventions in a managed care setting, or equivalent combination of relevant education and experience.
Demonstrated solid business writing experience.
Proficiency with data analysis, manipulation and interpretation.
Intermediate knowledge and understanding of HEDIS and NCQA.
Critical-thinking, problem-solving and analytical skills.
Attention to detail and organizational skills.
Ability to navigate change with flexibility and a positive outlook.
Ability to work independently in a fast-paced, deadline-driven environment.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency, and ability to learn new information systems and software programs.

Preferred Qualifications

Experience with data reporting, analysis, and interpretation.
Experience with Medicaid, Medicare, and/or Marketplace government-sponsored programs.
Certified Professional in Health Quality (CPHQ).
Certified HEDIS Compliance Auditor (CHCA).

Registered Nurse (RN). If licensed, license must be active and unrestricted in state of practice.
*

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

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hedis jobs in ohio

Sr Quality Improvement/HEDIS Spec, Health Plan Interventions (Remote In Ohio)

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