Top 131 Hedis Jobs in Remote

Clinical Quality Consultant NP
Elevance Health —Grand Prairie, TX
- Full-time
- Remote
- Nursing
- Current TB test
- RN License
- Employee stock purchase plan
- Paid holidays
Business Analyst HEDIS Role
Intone Networks —Remote
- Contract
- Research
- SQL
- Senior level
Director, Quality & Process Improvement, HEDIS Audit
Centene —Remote
- $118,400 - $219,000 a year
- Full-time
- Remote
- Background check
- 6 years
- Bachelor's degree
- Paid holidays
- Health insurance
Remote HEDIS Nurse Reviewer – New England Region
Martin's Point Health Care —Remote
- $86,926 - $107,379 a year
- Full-time
- Remote
- Nursing
- RN License
- 5 years
Quick Apply
5d
Health Plan Auditor I
Health Services Advisory Group, Inc. —Remote
- $62,000 - $70,000 a year
- Remote
- Microsoft Word
- Microsoft Outlook
- Public speaking
Healthcare Auditor II
Health Services Advisory Group, Inc. —Remote
- $80,000 - $90,000 a year
- Full-time
- Remote
- Microsoft Word
- Microsoft Outlook
- Writing skills
- Paid holidays
- Health insurance
HEDIS User Acceptance Testing Analyst - 2374852
Optum —Eden Prairie, MN
- $127,421 - $161,154 a year
- Full-time
- Remote
- 5 years
- Pass drug screening
- Research
- Employee stock purchase plan
- Health insurance
3d
Outpatient Clinical Documentation Specialist
Boston Medical Center —Remote
- $27.88 - $40.38 an hour
- Full-time
- Remote
- Nursing
- 5 years
- Computer literacy
- Health insurance
- Dental insurance
Population Health Analyst
Software Technology Inc —Remote
- Remote
- Microsoft Excel
- Research
- Mid-level
Quick Apply
Quality Performance Strategist
WellSense Health Plan —Remote
- $77,000 - $111,500 a year
- Full-time
- Background check
- Microsoft Access
- Research
- Health insurance
- Dental insurance
Quality Improvement Specialist
Evergreen Nephrology —Remote
- $20 - $24 an hour
- Remote
- Microsoft Outlook
- HIPAA
- Mid-level
- Paid parental leave
- Health savings account
Quick Apply
Medical Coder – AWV & HEDIS Gap Closure Virtual Clinic - Remote
CareTalk Health —Remote
- $30 an hour
- Full-time
- Remote
- Background check
- Clinic experience
- Mid-level
Quick Apply
Lead, Data Quality/Integrity – Clinical Abstraction Operations
Humana —Remote
- $106,900 - $147,000 a year
- Full-time
- Remote
- Nursing
- Computer Science
- Research
- Paid parental leave
- Paid holidays
8d
Senior Specialist, Quality Program Management & Performance (Remote)
Molina Healthcare —Saint Petersburg, FL
- $54,922 - $107,099 a year
- Full-time
- Remote
- RN License
- Mid-level
- Analysis skills
- Health insurance
Nurse Educator & Quality Assurance Specialist (Contractor)
Everlywell —Remote
- Contract
- Remote
- Google Workspace
- RN License
- 5 years
HB Second Level Reviewer - Remote
UC San Diego Health —San Diego, CA
- $37.93 - $68.68 an hour
- 8 hour shift
- Remote
- Customer service
- Pass drug screening
- 3 years
Senior Quality Data Analyst - Remote
EmblemHealth —New York, NY
- $68,040 - $118,800 a year
- Remote
- Mid-level
- Finance
- Master's degree
Senior Specialist, Provider Engagement- Quality HEDIS Risk (Remote)
Molina Healthcare —Miami, FL
- $54,922 - $107,099 a year
- Full-time
- Remote
- Nursing
- 3 years
- Analysis skills
- Health insurance
Lead Quality Data Analyst - Remote
EmblemHealth —New York, NY
- $77,760 - $149,040 a year
- Remote
- 5 years
- Finance
- Master's degree
HB Outpatient Second Level Reviewer – Remote
UC San Diego Health —San Diego, CA
- $37.93 - $68.68 an hour
- 8 hour shift
- Remote
- Customer service
- Pass drug screening
- 3 years

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Clinical Quality Consultant NP

Elevance Health -
Grand Prairie, TX

Apply Now

Job Details

Full-time

Benefits

Employee stock purchase plan
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

Nursing
RN License
Nurse Practitioner (NP)
Healthcare diagnosis
Nursing

Full Job Description

Location: Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Responsible for quality documentation, coding and value capture.

How You'll Make a Difference:

Primary duties may include, but are not limited to: Focus on chart reviews by supplying clinical expertise to ensure full accurate and appropriate diagnosis, documentation, coding and care.
Will review all provider visit medical encounters and apply most appropriate diagnosis codes.
Overall accountability for the HCC/Risk Adjustment of goals and workflows to support value capture initiatives and high-quality clinical documentation.
Chart reviews for closing HEDIS care opportunities.
Liaison to coding team.
Chart reviews for closing HEDIS care opportunities to ensure practice and health plan success.
Participate in peer review of medical documentation for completed visit notes and patient profile information in EMR.
Reviews and corrects any ICD-10 codes that have been assigned in charts.
Provide feedback to the provider for improved documentation to support specific codes.

Minimum Requirements:

Requires an MS in Nursing and minimum of 3 years experience in applying appropriate diagnosis in the Medicare HCC model and/or CMS Risk Adjustment Model; or any combination of education and experience, which would provide an equivalent background.
Requires a current, active, valid and unrestricted RN license and NP license in applicable state(s).
Multi-state licensure is required if this individual is providing services in multiple states.
For Carelon Health, satisfactory completion of a Tuberculosis test is a requirement for this position.
Travels to worksite and other locations as necessary.

Preferred skills, qualifications and experiences:

Prefer AAPC Certified Risk Adjustment Coder

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $114,608 to $199.056

Locations: Minnesota

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, paid time off, stock, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

hedis jobs in remote

Clinical Quality Consultant NP

Business Analyst HEDIS Role

Director, Quality & Process Improvement, HEDIS Audit

Remote HEDIS Nurse Reviewer – New England Region

Health Plan Auditor I

Healthcare Auditor II

HEDIS User Acceptance Testing Analyst - 2374852

Outpatient Clinical Documentation Specialist

Population Health Analyst

Quality Performance Strategist

Quality Improvement Specialist

Medical Coder – AWV & HEDIS Gap Closure Virtual Clinic - Remote

Lead, Data Quality/Integrity – Clinical Abstraction Operations

Senior Specialist, Quality Program Management & Performance (Remote)

Nurse Educator & Quality Assurance Specialist (Contractor)

HB Second Level Reviewer - Remote

Senior Quality Data Analyst - Remote

Senior Specialist, Provider Engagement- Quality HEDIS Risk (Remote)

Lead Quality Data Analyst - Remote

HB Outpatient Second Level Reviewer – Remote

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