Partner with Quality Analytics and HEDIS teams to support collection, validation, and reporting of provider quality data. * Assist with management of supplemental data submissions and provider data ...
Partner with Quality Analytics and HEDIS teams to support collection, validation, and reporting of provider quality data. * Assist with management of supplemental data submissions and provider data ...
Partner with Quality Analytics and HEDIS teams to support collection, validation, and reporting of provider quality data. * Assist with management of supplemental data submissions and provider data ...
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Partner with Quality Analytics and HEDIS teams to support collection, validation, and reporting of provider quality data. * Assist with management of supplemental data submissions and provider data ...
Partner with Quality Analytics and HEDIS teams to support collection, validation, and reporting of provider quality data. * Assist with management of supplemental data submissions and provider data ...
Partner with Quality Analytics and HEDIS teams to support collection, validation, and reporting of provider quality data. * Assist with management of supplemental data submissions and provider data ...
WI · On-site
$145 - $200/hr
End-to-end support across HEDIS, CAHPS, HOS, Part D, and SNP performance, tailored to each ... assist you. #J-18808-Ljbffr
New
WI · On-site
$145 - $200/hr
End-to-end support across HEDIS, CAHPS, HOS, Part D, and SNP performance, tailored to each ... assist you. #J-18808-Ljbffr
New
WI · On-site
$65 - $90/hr
... HEDIS CAT II, E/M codes according to the Centers for Medicare & Medicaid Services (CMS) requirements for both professional and hospital billing. May assist in training and reviewing the work of other ...
Posted today
WI · On-site
$65 - $90/hr
... HEDIS CAT II, E/M codes according to the Centers for Medicare & Medicaid Services (CMS) requirements for both professional and hospital billing. May assist in training and reviewing the work of other ...
Posted today
Demonstrates knowledge of NCQA and HEDIS Standards and participates in initiative to achieve accreditation and improve HEDIS compliance rates * Ability to assist with performing of case/barrier ...
Demonstrates knowledge of NCQA and HEDIS Standards and participates in initiative to achieve accreditation and improve HEDIS compliance rates * Ability to assist with performing of case/barrier ...
Demonstrates knowledge of NCQA and HEDIS Standards and participates in initiative to achieve accreditation and improve HEDIS compliance rates * Ability to assist with performing of case/barrier ...
Demonstrates knowledge of NCQA and HEDIS Standards and participates in initiative to achieve accreditation and improve HEDIS compliance rates * Ability to assist with performing of case/barrier ...
Demonstrates knowledge of NCQA and HEDIS Standards and participates in initiative to achieve accreditation and improve HEDIS compliance rates * Ability to assist with performing of case/barrier ...
Demonstrates knowledge of NCQA and HEDIS Standards and participates in initiative to achieve accreditation and improve HEDIS compliance rates * Ability to assist with performing of case/barrier ...
Schedule and assist with committee and sub-committee preparation. Assist in investigation and ... Qualifications What We Look For: RN required 2+ years of HEDIS or chart review experience Computer ...
Schedule and assist with committee and sub-committee preparation. Assist in investigation and ... Qualifications What We Look For: RN required 2+ years of HEDIS or chart review experience Computer ...
RN Case Management Coord
Janesville, WI · On-site
$63K - $97K/yr
Demonstrates knowledge of NCQA and HEDIS Standards and participates in initiative to achieve accreditation and improve HEDIS compliance rates * Ability to assist with performing of case/barrier ...
RN Case Management Coord
Janesville, WI · On-site
$63K - $97K/yr
Demonstrates knowledge of NCQA and HEDIS Standards and participates in initiative to achieve accreditation and improve HEDIS compliance rates * Ability to assist with performing of case/barrier ...
WI · On-site
$200 - $300/hr
... assistants, case managers and specialists to insure seamless patient care. * Review and address quality metrics, including HEDIS and STAR measures, to optimize clinical performance and patient ...
WI · On-site
$200 - $300/hr
... assistants, case managers and specialists to insure seamless patient care. * Review and address quality metrics, including HEDIS and STAR measures, to optimize clinical performance and patient ...
Care Facilitator - (Spanish Speaking)
Newburg, WI · On-site
$20.42/hr
Acts as HEDIS champion for the PCP by providing visibility of HEDIS needs for scheduled patients ... Graduation from a nationally accredited Medical Assistant program preferred * A minimum of 1 year ...
Posted today
Care Facilitator - (Spanish Speaking)
Newburg, WI · On-site
$20.42/hr
Acts as HEDIS champion for the PCP by providing visibility of HEDIS needs for scheduled patients ... Graduation from a nationally accredited Medical Assistant program preferred * A minimum of 1 year ...
Posted today
Pharmacist
Brookfield, WI · On-site +1
... NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and ... Job Responsibilities: * Assist with Commercial compliance workplan oversite * PBM follow up ...
Pharmacist
Brookfield, WI · On-site +1
... NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and ... Job Responsibilities: * Assist with Commercial compliance workplan oversite * PBM follow up ...
Pharmacist
Menasha, WI · On-site +1
... NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and ... Job Responsibilities: * Assist with Commercial compliance workplan oversite * PBM follow up ...
Pharmacist
Menasha, WI · On-site +1
... NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and ... Job Responsibilities: * Assist with Commercial compliance workplan oversite * PBM follow up ...
Pharmacist
Brookfield, WI · On-site +1
... NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and ... Job Responsibilities: * Assist with Commercial compliance workplan oversite * PBM follow up ...
Pharmacist
Brookfield, WI · On-site +1
... NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and ... Job Responsibilities: * Assist with Commercial compliance workplan oversite * PBM follow up ...
Pharmacist
Brookfield, WI · On-site +1
... NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and ... Job Responsibilities: * Assist with Commercial compliance workplan oversite * PBM follow up ...
Pharmacist
Brookfield, WI · On-site +1
... NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and ... Job Responsibilities: * Assist with Commercial compliance workplan oversite * PBM follow up ...
Pharmacist
Menasha, WI · On-site +1
... NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and ... Job Responsibilities: * Assist with Commercial compliance workplan oversite * PBM follow up ...
Pharmacist
Menasha, WI · On-site +1
... NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and ... Job Responsibilities: * Assist with Commercial compliance workplan oversite * PBM follow up ...
Pharmacist
Menasha, WI · On-site
... NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and ... Job Responsibilities: * Assist with Commercial compliance workplan oversite * PBM follow up ...
Pharmacist
Menasha, WI · On-site
... NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and ... Job Responsibilities: * Assist with Commercial compliance workplan oversite * PBM follow up ...
Bilingual Spanish/English Routine Primary Care APP (NP/PA)- Telehealth
Oregon, WI · On-site
$106.25 - $143.75/hr
Active Nurse Practitioner (APRN) or Active Physician Assistant (PA) license in good standing and ... Familiarity with value-based care models, population health management, and quality metrics (HEDIS ...
New
Bilingual Spanish/English Routine Primary Care APP (NP/PA)- Telehealth
Oregon, WI · On-site
$106.25 - $143.75/hr
Active Nurse Practitioner (APRN) or Active Physician Assistant (PA) license in good standing and ... Familiarity with value-based care models, population health management, and quality metrics (HEDIS ...
New
Center Clinical Manager
Oregon, WI · On-site
$54.36 - $77.65/hr
Uses data analytics and dashboards to assist with the development and execution of business strategies that increase revenue and quality ratings (HEDIS/STARS/Clinical Gaps) and support our core model.
New
Center Clinical Manager
Oregon, WI · On-site
$54.36 - $77.65/hr
Uses data analytics and dashboards to assist with the development and execution of business strategies that increase revenue and quality ratings (HEDIS/STARS/Clinical Gaps) and support our core model.
New
Assistant Hedis information
What are the roles and responsibilities of an Assistant HEDIS?
An Assistant HEDIS supports the Healthcare Effectiveness Data and Information Set (HEDIS) process by assisting with data collection, record review, and reporting for healthcare organizations. Their responsibilities typically include gathering medical records, verifying data accuracy, coordinating with providers, and helping with documentation to ensure compliance with HEDIS measures. They play a key role in quality improvement initiatives and help organizations meet regulatory and accreditation requirements.
What are the key skills and qualifications needed to thrive as an Assistant HEDIS?
To thrive as an Assistant HEDIS, you need a solid understanding of healthcare quality measures, data collection, and medical terminology, often supported by a background in health information management or a related field. Familiarity with HEDIS software, electronic medical records (EMRs), and proficiency in Microsoft Excel are typically required, and certification as a Registered Health Information Technician (RHIT) is a plus. Strong attention to detail, organizational skills, and effective communication are essential soft skills for managing sensitive data and collaborating with clinical staff. These abilities ensure accurate data reporting, compliance with healthcare standards, and contribute to the overall quality improvement efforts of healthcare organizations.
What is the difference between Assistant Hedis vs Hedis Coordinator?
| Aspect | Assistant Hedis | Hedis Coordinator |
|---|---|---|
| Certifications | Typically requires a healthcare-related certification or experience | Often requires similar certifications, with additional case management or healthcare coordination credentials |
| Work Environment | Assists in clinical or administrative tasks within healthcare settings | Manages HEDIS data collection and quality improvement initiatives in healthcare organizations |
| Employer & Industry | Healthcare providers, insurance companies, Medicaid/Medicaid managed care | Health plans, Medicaid agencies, healthcare quality organizations |
| Search & Comparison Intent | People looking for entry-level or supportive roles in HEDIS | Individuals seeking roles focused on HEDIS data management and quality assurance |
The Assistant Hedis role primarily supports HEDIS-related tasks with a focus on assisting healthcare teams, while the Hedis Coordinator oversees data collection, analysis, and quality improvement efforts. Both roles require healthcare knowledge, but the Coordinator position typically involves more responsibility for data management and compliance.
What are the most commonly searched types of Hedis jobs in Wisconsin?
The most popular types of Hedis jobs in Wisconsin are:
What are popular job titles related to Assistant Hedis jobs in Wisconsin?
For Assistant Hedis jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Assistant Hedis jobs in Wisconsin look for?
The top searched job categories for Assistant Hedis jobs in Wisconsin are:
What cities in Wisconsin are hiring for Assistant Hedis jobs?
Cities in Wisconsin with the most Assistant Hedis job openings:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 10 days ago
Key responsibilities
Coordinate and manage provider quality initiatives to improve healthcare quality outcomes and performance measures.
Support provider performance monitoring by analyzing data, interpreting results, and recommending improvement strategies.
Assist in administering provider incentive programs, including performance tracking, reporting, and validation.
Medica rating
8.4
Based on 22 frontline employees who took The Breakroom Quiz
124th of 315 rated insurance
Job description
Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.
We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.
The Provider Quality Program Manager II is responsible for coordinating and managing provider quality initiatives designed to improve healthcare quality outcomes and performance measures across Medica's lines of business. This role serves as a key partner between Quality, Clinical Provider Partnerships, Network Management, and operational teams to support provider performance improvement strategies, quality reporting, incentive program administration, and care gap closure efforts.
Working with limited supervision, this position manages assigned projects and program components, prepares and analyzes performance data, develops recommendations, and collaborates with internal and external stakeholders to achieve quality objectives, including Medicare Star Ratings, Medicaid quality, HEDIS performance, and value-based care goals. Performs other duties as assigned.
Key Accountabilities
Provider Quality Program Management
Provider Performance Monitoring and Improvement
Provider Incentive Program Administration
Quality Data Management and Reporting
Cross-Functional Collaboration
Care Gap Closure and Quality Improvement
Required Qualifications
Preferred Qualifications
This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN or Madison, WI.
The full salary grade for this position is $70,200 - $120,400. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $70,200 - $105,315. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.
The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.
Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.
We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.
We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.
The Provider Quality Program Manager II is responsible for coordinating and managing provider quality initiatives designed to improve healthcare quality outcomes and performance measures across Medica's lines of business. This role serves as a key partner between Quality, Clinical Provider Partnerships, Network Management, and operational teams to support provider performance improvement strategies, quality reporting, incentive program administration, and care gap closure efforts.
Working with limited supervision, this position manages assigned projects and program components, prepares and analyzes performance data, develops recommendations, and collaborates with internal and external stakeholders to achieve quality objectives, including Medicare Star Ratings, Medicaid quality, HEDIS performance, and value-based care goals. Performs other duties as assigned.
Key Accountabilities
Provider Quality Program Management
- Coordinate implementation and ongoing management of provider quality initiatives across assigned provider groups and lines of business
- Support execution of quality improvement strategies focused on Medicare Stars, Medicaid quality measures, HEDIS, and value-based care programs
- Monitor program milestones, deliverables, and outcomes to ensure achievement of established goals
- Provide program management support for cross-functional quality improvement efforts
Provider Performance Monitoring and Improvement
- Synthesize insights to identify improvement opportunities, emerging risks, and priority areas for intervention.
- Inform and consult on provider performance reports, scorecards, dashboards, and presentations that support organizational and provider decision-making.
- Serve as a quality subject matter expert to clinical provider partnerships team by interpreting performance results, recommending evidence-based improvement strategies, and informing provider engagement discussions.
- Monitor trends and key indicators, providing proactive recommendations and escalating significant risks, barriers, or performance concerns to appropriate stakeholders.
- Evaluate the effectiveness of improvement initiatives and provide ongoing guidance, insights, and best practices to support sustained performance improvement.
Provider Incentive Program Administration
- Support administration of provider quality incentive programs, including performance tracking, reporting, and operational processes
- Assist with validating and reconciling provider performance results and attribution methodologies
- Collaborate with finance, network, and quality teams to support accurate incentive calculations and program reporting
- Maintain documentation and operational procedures related to incentive program administration
Quality Data Management and Reporting
- Partner with Quality Analytics and HEDIS teams to support collection, validation, and reporting of provider quality data.
- Assist with management of supplemental data submissions and provider data collection activities
- Support chart retrieval, provider communication, and quality data collection efforts as needed
- Ensure data integrity and compliance with regulatory and organizational requirements
Cross-Functional Collaboration
- Collaborate with Population Health and Quality Improvement, Clinical Provider Partnerships, Network Management, Value-Based Care Reporting and Analytics, Quality Analytics, HEDIS teams and other Clinical teams to support quality initiatives
- Participate in implementation of quality-related contractual requirements and operational initiatives
- Contribute subject matter expertise for quality performance improvement projects and workgroups
- Support responses to internal requests, audits, and regulatory reporting activities related to provider quality programs
Care Gap Closure and Quality Improvement
- Assist in development and implementation of provider-focused interventions to improve quality outcomes
- Monitor effectiveness of quality improvement activities and recommend enhancements
- Support initiatives focused on preventive care, chronic condition management, member experience and member care gap closure
- Identify best practices and opportunities for continuous improvement
Required Qualifications
- Bachelor's degree or equivalent experience in related field
- 5+ years of work experience beyond degree in healthcare quality, provider relations, population health, health plan operations, value-based care, program management, or related healthcare field
Preferred Qualifications
- Experience with Medicare Star Ratings, HEDIS, Medicaid quality programs, and/or value-based care initiatives.
- Experience interacting with provider organizations, clinics, health systems, or provider networks.
- Experience using healthcare data to drive performance improvement efforts.
- Program/Project management experience within a health plan, provider organization, or healthcare consulting environment.
- Clinical background (RN, LPN, or other healthcare licensure) preferred.
- Working knowledge of healthcare quality improvement principles and performance measurement.
- Understanding of Medicare, Medicaid, Commercial, and value-based care quality programs.
- Ability to analyze, interpret, and communicate complex healthcare data and performance metrics.
- Strong project management and organizational skills.
- Ability to manage multiple priorities and meet deadlines.
- Effective written, verbal, and presentation communication skills.
- Strong relationship-building and stakeholder management capabilities.
- Proficiency with Microsoft Office applications and healthcare reporting tools.
- Ability to work independently while collaborating effectively across teams.
- Demonstrated problem-solving, critical thinking, and continuous improvement mindset.
This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN or Madison, WI.
The full salary grade for this position is $70,200 - $120,400. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $70,200 - $105,315. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.
The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.
Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.
We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.