Top 57 Hedis Jobs in Massachusetts

SCO Assessment Nurse Case Manager - Lowell
Fallon Health —Lowell, MA
- $95,000 - $100,000 a year
- Full-time
- Nursing
- RN License
- Mid-level
SCO Assessment Nurse Case Manager - Lawrence/Lowell
Fallon Health —Lawrence, MA
- $95,000 - $100,000 a year
- Full-time
- Nursing
- RN License
- Mid-level
SCO RN Case Manager - Lawrence/Lowell
Fallon Health —Lawrence, MA
- Full-time
- Nursing
- RN License
- HIPAA
SCO Assessment Nurse Case Manager - Lunenburg/Westford
Fallon Health —Lunenburg, MA
- $95,000 - $100,000 a year
- Full-time
- Nursing
- RN License
- Mid-level
Assessment Nurse Case Manager - Fitchburg/Gardner
Fallon Health —Leominster, MA
- $95,000 - $100,000 a year
- Full-time
- Nursing
- RN License
- Mid-level
10d
Nurse Practitioner
ComplexCare Solutions —Barnstable County, MA
- $2,400 - $10,000 a month
- PRN
- Bilingual
- CPR Certification
- RN License
- Health insurance
- 401(k)
Quick Apply
4d
Nurse Practitioner
ComplexCare Solutions —Suffolk County, MA
- $2,400 - $10,000 a month
- PRN
- Bilingual
- CPR Certification
- RN License
- Health insurance
- 401(k)
Quick Apply
4d
Cardiology Nurse Practitioner/ Physician Assistant
MedElite Group, LLC. —Deerfield, MA
- $60,000 - $90,000 a year
- CPR Certification
- Nursing
- Skilled nursing facility
- Paid time off
Quick Apply
Cardiology Nurse Practitioner/ Physician Assistant
MedElite Group, LLC. —Worcester, MA
- $60,000 - $90,000 a year
- CPR Certification
- Nursing
- Skilled nursing facility
- Paid time off
Quick Apply
Cardiology Nurse Practitioner/ Physician Assistant
MedElite Group, LLC. —Springfield, MA
- $60,000 - $90,000 a year
- CPR Certification
- Nursing
- Skilled nursing facility
- Paid time off
Quick Apply
Nurse Practitioner
ComplexCare Solutions —Hampden County, MA
- $2,400 - $10,000 a month
- PRN
- Bilingual
- CPR Certification
- RN License
- Health insurance
- 401(k)
Quick Apply
4d
Nurse Practitioner
ComplexCare Solutions —Bristol County, MA
- $2,400 - $10,000 a month
- PRN
- Bilingual
- CPR Certification
- RN License
- Health insurance
- 401(k)
Quick Apply
4d
Principal Systems Management Analyst - Epic Healthy Planet
Optum —Auburndale, MA
- $112,700 - $193,200 a year
- Full-time
- Remote
- Computer science
- Computer Science
- 5 years
12d
Analyst, Quality
NeighborHealth —Boston, MA
- $89,440 - $137,280 a year
- Online Application
- Background check
- Mid-level
- SQL
Specialist, Health Plan Provider Engagement - RADV (Remote in MA)
Molina Healthcare —Waltham, MA
- $52,199 - $101,788 a year
- Full-time
- Remote
- Nursing
- Mid-level
- Analysis skills
- Health insurance
13d
Director of Quality Improvement, Member Experience, & Health Equity
Baystate Health —Springfield, MA
- $158,371 - $215,342 a year
- Full-time
- Hybrid work
- Nursing
- 5 years
- Office
Specialist, Health Plan Provider Engagement - RADV (Remote in MA)
Molina Healthcare, Inc. —Massachusetts
- $52,199 - $101,788 a year
- Full-time
- Remote
- Nursing
- Mid-level
- Analysis skills
- Health insurance
10d
Quality Practice Liaison (Must be licensed in Arizona or Multi-State)
CVS Health —Massachusetts
- $54,095 - $155,538 a year
- Full-time
- Remote
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
11d
Senior Quality Data Analyst
Beth Israel Lahey Health —Charlestown, MA
- $75,000 - $125,000 a year
- Full-time
- 5 years
- Master's degree
- Bachelor's degree
13d
RN Reviewer
Cohere Health —Boston, MA
- $33 - $35 an hour
- Weekends as needed
- Remote
- Google Workspace
- Nursing
- RN License
- Paid parental leave
- Health savings account
Quick Apply

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hedis jobs near massachusetts

SCO Assessment Nurse Case Manager - Lowell

Fallon Health -
Lowell, MA

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Job Details

Full-time
$95,000 - $100,000 a year

Qualifications

Collaborate with healthcare professionals
RN License
Interviewing clients
Driver's License
Driving
Telehealth experience
Multidisciplinary team collaboration for treatment planning

Full Job Description

Overview:

The Senior Care Options Assessment Nurse Case Manager will be covering and visiting members in Lowell.

About us:

Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.

Brief summary of purpose:

The Assessment Nurse Case Manager completes face-to-face home visits for new enrollees within 30 days of enrollment to onboard and completes regulatory assessments. The Assessment Nurse Case Manager completes in person Health Risk Assessments (HRAs) in accordance with members assigned frequency. The Assessment Nurse Case Manager completes all new Personal Care Attendant (PCA) Assessments using the integrated time for task tool and well as yearly PCA reevaluations. The Assessment Nurse Case Manager is also responsible for the timely and accurate submission of yearly (and when there is a significant change in status) MDS assessments. Assessments are done primarily in person but may at times be completed telephonically.

Responsibilities:

Overview

Conducts home visits for onboarding and regulatory assessments.
Completes HRAs and PCA assessments.
Submits MDS assessments.
Provides education on NaviCare case management program.
Conducts telephonic assessments when appropriate.
Collaborates with Care Team.
Completes LTSS evaluations and collaborates with UM.

Member Assessment, Education & Advocacy

Conducts in-home assessments with motivational and culturally sensitive interviewing.
Performs medication reconciliation.
Completes State-required assessment tools per contract.
Conducts functional assessments for LTSS programs.
Participates in training and audits.
Completes telephonic/virtual assessments.
Maintains program/policy knowledge to educate members.
Supports HEDIS, Medicare 5 Star, and other initiatives.

Qualifications:

Education:

Graduate from an accredited school of nursing mandatory and a Bachelors (or advanced) degree in nursing or a health care related field preferred.

License:

Active, unrestricted license as a Registered Nurse in Massachusetts

Certification:

Certification in Case Management strongly desired

Other: Driving your personal motor vehicle is an essential job function of this position and the following requirements apply:

Must possess a valid drivers’ license
Must attest to no disqualifiers per Driver Safety Policy
Must possess and provide proof of minimal state required auto insurance
Must have reliable transportation

Experience:

1+ years of clinical RN experience with complex medical, behavioral, and social co-morbidities.
Ability to conduct assessments in-person and telehealth.
Ability to work on interdisciplinary teams.
Skill in screening social determinants of health.
Strong communication and interviewing skills.
Problem-solving skills and adaptability.
Knowledge or willingness to learn regulatory requirements.
Preferred experience: Home Health, OASIS/MDS, Medicare/Medicaid, face-to-face member interactions.
Reliable home internet.

Pay Range Disclosure:

In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $95,000 - $100,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities.

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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hedis jobs in massachusetts

SCO Assessment Nurse Case Manager - Lowell

SCO Assessment Nurse Case Manager - Lawrence/Lowell

SCO RN Case Manager - Lawrence/Lowell

SCO Assessment Nurse Case Manager - Lunenburg/Westford

Assessment Nurse Case Manager - Fitchburg/Gardner

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Principal Systems Management Analyst - Epic Healthy Planet

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Specialist, Health Plan Provider Engagement - RADV (Remote in MA)

Director of Quality Improvement, Member Experience, & Health Equity

Specialist, Health Plan Provider Engagement - RADV (Remote in MA)

Quality Practice Liaison (Must be licensed in Arizona or Multi-State)

Senior Quality Data Analyst

RN Reviewer

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