Top 69 Medicare remote Jobs in Columbus

Sr Quality Improvement/HEDIS Spec, Health Plan Interventions (Remote In Ohio)
Molina Healthcare —Columbus, OH
- $54,922 - $107,099 a year
- Full-time
- Remote
- RN License
- Writing skills
- Analysis skills
- Health insurance
Provider Enrollment & Credentialing Subject Matter Expert (SME)
Brittany Wyche, LLC —Columbus, OH
- $75 - $110 an hour
- Contract
- Hybrid work
- Analysis skills
- Senior level
- Communication skills
Quick Apply
1d
Assessment Specialist SRS - Franklin and Surrounding Counties
CareStar, Inc. —Columbus, OH
- Full-time
- RN License
- Mid-level
- Bachelor's degree
- Paid holidays
- Health insurance
Quick Apply
Homecare - Revenue Cycle Manager – Remote
PurposeCare —Columbus, OH
- $80,000 - $95,000 a year
- On call
- Travel
- Home Health
- Organizational skills
Quick Apply
Remote Physician Coding Specialist II
Mount Carmel —Columbus, OH
- Full-time
- Remote
- Surgery
- Mid-level
- High school diploma or GED
LPN - Advanced Care Planning Specialist, Remote
Aledade PBC —Columbus, OH
- $28.85 an hour
- 8 hour shift
- Remote
- Spanish
- Nursing
- Mid-level
- Paid parental leave
- Paid holidays
Quick Apply
Intake Specialist - Franklin and Surrounding Counties
CareStar, Inc. —Columbus, OH
- Full-time
- RN License
- Mid-level
- Home Health
- Paid holidays
- Health insurance
Quick Apply
BH Insurance/Precert Specialist
Nationwide Children's Hospital —Columbus, OH
- Full-time
- CPR Certification
- BLS Certification
- High school diploma or GED
Clinical Manager - Specialized Recovery Services (OH)
CareStar, Inc. —Columbus, OH
- Full-time
- RN License
- Driver's License
- Bachelor's degree
- Paid holidays
- Health insurance
Quick Apply
1d
Medicare Sales Field Agent - Columbus, OH.
Humana —Columbus, OH
- $80,000 - $125,000 a year
- Weekends as needed
- Local
- Public speaking
- Driver's License
- Paid holidays
- Health insurance
Contracts Technician Associate
Ensemble RCM LLC —Columbus, OH
- $46,900 - $89,850 a year
- Full-time
- Mid-level
- Office
- High school diploma or GED
- Tuition reimbursement
14d
Licensed Mental Health Therapist
Compassionate Counseling for Seniors and Caregivers —Westerville, OH
- $55 - $75 an hour
- Contract
- Hybrid work
- Private practice
- LMFT
- Master of Social Work
- Flexible schedule
Quick Apply
Hospice Social Worker
Generation Hospice —Westerville, OH
- $30 - $38 an hour
- Part-time
- Hybrid work
- CPR Certification
- Experience working with individuals with disabilities
- BLS Certification
Quick Apply
Inpatient Coding Auditor
Huron Managed Services LLC —Columbus, OH
- $38.46 - $52.40 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Dental insurance
Quick Apply
1d
Senior Healthcare Business Analyst / Lean Six Sigma Consultant
Brittany Wyche, LLC —Columbus, OH
- $70 - $95 an hour
- Contract
- Hybrid work
- Background check
- Analysis skills
- Senior level
Quick Apply
1d
Clinical Supervisor SRS - Franklin and Surrounding Counties
CareStar, Inc. —Columbus, OH
- Full-time
- RN License
- Social Work
- 1 year
- Paid holidays
- Health insurance
Quick Apply
IT Project Manager
Medical Mutual of Ohio —Dublin, OH
- Hybrid work
- Mid-level
- Office
- 3 years
- Health savings account
- Disability insurance
Financial Analyst
Medical Mutual of Ohio —Dublin, OH
- Hybrid work
- Microsoft Access
- 5 years
- Mid-level
- Health savings account
- Disability insurance
Corporate Counsel
Quantum Health —Dublin, OH
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Wellness program
- Dental insurance
Quick Apply
Nurse Practitioner, Parkersburg, WV- Hybrid Remote
DAVITA —Westerville, OH
- $118,000 - $135,000 a year
- Full-time
- Hybrid work
- Microsoft Word
- CPR Certification
- Microsoft Outlook
- Continuing education credits
- Health insurance
12d

I want to receive the latest job alert for medicare remote in columbus

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

medicare remote jobs near columbus

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

Molina Healthcare -
Columbus, 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

Refine Your Search

medicare remote jobs in columbus

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

Provider Enrollment & Credentialing Subject Matter Expert (SME)

Assessment Specialist SRS - Franklin and Surrounding Counties

Homecare - Revenue Cycle Manager – Remote

Remote Physician Coding Specialist II

LPN - Advanced Care Planning Specialist, Remote

Intake Specialist - Franklin and Surrounding Counties

BH Insurance/Precert Specialist

Clinical Manager - Specialized Recovery Services (OH)

Medicare Sales Field Agent - Columbus, OH.

Contracts Technician Associate

Licensed Mental Health Therapist

Hospice Social Worker

Inpatient Coding Auditor

Senior Healthcare Business Analyst / Lean Six Sigma Consultant

Clinical Supervisor SRS - Franklin and Surrounding Counties

IT Project Manager

Financial Analyst

Corporate Counsel

Nurse Practitioner, Parkersburg, WV- Hybrid Remote

I want to receive the latest job alert for medicare remote in columbus

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected