Quality Analyst Nurse HEDIS Candidates Sample Search Report

100%

L* G**

Sr. Program Manager: HEDIS - Quality Initiatives (Federal Employee Program). Blue Cross Blue Shield Association

Washington, District of Columbia, United States 10 years

Excellent fit—recent, explicit experience in HEDIS and Quality Initiatives, and listed as CPHQ, suggesting strong overall quality background. Sr Program Manager HEDIS/Quality → QI Lead → Manager QI (HEDIS/CAHPS) @ BCBS, Centene, Evolent. Excellent.

LinkedIn Email Phone

Work Experience

Evolent

Quality Improvement Lead (Payment Integrity) · 1 year 9 months

Centene Corporation

Manager QI - Regulatory Comunications /HEDIS Initiatives/ CAHPS- (Medicare /Medicaid/ Marketplace) · 5 years 8 months

Blue Cross Blue Shield Association

Sr Program Manager Quality and HEDIS initiatives (Federal Employment Program-FEP) · 2 years 10 months

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

project manager utilization management motivational interviewing mental health quality improvement resume bilingual spanish pmp healthcare medicare medicaid +8 more

100%

K S

RN, HEDIS Abstractor / Reviewer/ Over Reader, Utilization Review, Case Manager, Quality Assurance & Quality Improvement, Practice Advisor, Super-User Cerner-Hospital, Nurse Preceptor, Nurse Advocate, Team Lead

Ormond Beach, Florida, United States 34 years 11 months

This candidate is an excellent fit, working directly as an RN HEDIS Abstractor/Reviewer with specific mention of NCQA HEDIS standards and QI support. Ex-Care + Advocacy → Optum → Comprehensive Health. Excellent.

LinkedIn Email Phone

Work Experience

Florida Hospital

RN, Case Manager · 9 years

Optum

Clinical Data Abstractor, HEDIS RN · 4 months

State of Florida

School Nurse RN · 1 year 1 month

Central Florida Regional Hospital

RN, Case Manager, Social Worker/Discharge Planner · 2 years

+ 6 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

utilization review computer skills interpersonal skills quality improvement quality assurance case management risk management innovation abstraction healthcare clinical assurance +8 more

100%

I N

Clinical Program Consultant for the HEDIS training team at UnitedHealthcare

Mobile, Alabama, United States 20 years 5 months

This candidate is an excellent fit, possessing explicit recent experience in HEDIS training, abstraction, and clinical quality management as a Nurse. Nurse → HEDIS Lead/Abstracter → Clinical Program Consultant (HEDIS team) at UHC/Anthem. Excellent.

LinkedIn Email Phone

Work Experience

Anthem Bluecross & Blueshield

HEDIS Lead · 2 years

UnitedHealthcare

Clinical Program Consultant for the HEDIS training team

THE EAR NOSE AND THROAT CLINIC LIMITED

Nurse/Allergy Nurse · 1 year 6 months

U.S. Coast Guard

FS2 United States Coast Guard · 4 years 1 month

+ 5 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

clinical training allergy signs injections insurance payments pharmacy drawing food ekg abstraction +3 more

100%

T* P**

Experienced Quality Management Leader

Waycross, Georgia, United States 23 years 11 months

This candidate is an excellent fit, having held dedicated Manager and Outreach Coordinator roles specifically managing HEDIS rates and audits while also being a Registered Nurse with broad quality leadership experience. Director, Health Care Quality Management (HEDIS) at Aetna → Healthcare Quality Management Supervisor (HEDIS) at Aetna → Outreach Coordinator (HEDIS) at Coventry Health Care → Registered Nurse roles. Excellent.

LinkedIn Email Phone

Work Experience

Coventry Health Care, an Aetna Company

Outreach Coordinator (HEDIS) · 4 years 11 months

Aetna, a CVS Health Company

Healthcare Quality Management Supervisor (HEDIS) · 3 years 5 months

Aetna, a CVS Health Company

Director, Health Care Quality Management · 1 year 10 months

Beaver Valley Health and Rehabilitation Center

Registered Nurse · 1 year 3 months

+ 5 more positions

Qualification Criteria 3 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

director strategy operations health cancer brochures healthcare management rates teaching audit nursing +5 more

100%

R P**

Senior Director, Quality Improvement at Centene Corporation

Greensboro, North Carolina, United States 20 years 7 months

Perfect fit for a Quality Analyst Nurse role centered on HEDIS, as this candidate currently directs HEDIS operations, manages related vendors, and ensures NCQA compliance for various government lines of business. Director of Clinical Services and Quality → Associate Director QI Tech → Director QI, overseeing HEDIS Operations, hybrid projects, and NCQA compliance. Excellent.

LinkedIn Email Phone

Work Experience

University Health Plans

Medical and Financial Data Analyst · 6 months

National Prescription Administrators

Patient Health Management Coordinator · 6 months

Amerigroup Corporation of New Jersey

Pharmacy Clinical Support Technician · 1 year 2 months

Centene Corporation

Director, Quality Improvement · 2 years 2 months

+ 6 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

director reports health management analysis database pharmacy clinical claims processing asthma ran +8 more

100%

D S

Manager of Performance Improvement

United States 18 years 9 months

This candidate has strong experience managing HEDIS performance and quality initiatives in a health plan setting. Meridian Health Plan → Clinical Data Engineer, managed HEDIS measure testing and performance goals, oversaw HEDIS reporting/roadmaps. Excellent.

LinkedIn Email Phone

Work Experience

Meridian Health Plan

Clinical Data Engineer · 7 months

Good Shepherd Credit Union

Member Services Representative · 6 years 6 months

Meridian Health Plan

HEDIS Coordinator · 1 year 10 months

Meridian Health Plan

Manager of Performance Improvement

Qualification Criteria 3 met, 1 not

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

responsible management accreditation rates reporting audit preparation education abstraction integrity efficiency training +8 more

100%

W** L

Director, HEDIS Quality at Elevance Health

Atlanta, Georgia, United States 22 years 3 months

This candidate is an excellent match, holding a senior director role specifically focused on Clinical HEDIS Quality, ensuring NCQA compliance. WellCare → Anthem/Elevance Health, 22+ years exp. Excellent.

LinkedIn Email Phone

Work Experience

ACS- INC

Claims Supervisor · 2 years 6 months

WellPoint

Manager II, Health Services · 5 months

Anthem, Inc.

Director, Clinical HEDIS Quality

Elevance Health

Director, Clinical HEDIS Quality

+ 4 more positions

Qualification Criteria 3 met, 1 not

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

director clinical claims adjustments health operations efficiency responsible medicaid education reports leadership +8 more

100%

B C

Clinical Quality Analyst, SR

Chattanooga, Tennessee, United States 44 years 6 months

This candidate has spent nearly two decades in roles directly titled HEDIS Clinical Quality Manager or HEDIS Clinical Contractor, combined with a Field Review Nurse background. Field Nurse → HEDIS Clinical Contractor → HEDIS Clinical Quality Manager at UHG/Optum. Excellent.

LinkedIn Email Phone

Work Experience

Care Wisconsin

Employee Health Nurse & Phlebotomy Supervisor · 6 years 8 months

University Physicians

Internal Medicine/Dermatology Clinic Nurse · 5 years 11 months

UW Health

Float Nurse - TLC, Cardiology, Ortho, Gen Med/Surgery, Oncology, Pediatrics · 5 years

EDS (Wisconsin HIRSP)

Utilization Review Nurse/Prior Authorization Appeals · 3 years 5 months

+ 6 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

clinical health phlebotomy accident chemicals surveillance strategy injury compliance safety legislation legal +8 more

100%

L M

HEDIS Lead at Elevance Health

Columbus, Ohio, United States 18 years 11 months

Perfect fit - this candidate is currently a HEDIS Lead who has deep experience as an RN, focusing heavily on HEDIS measure adherence and abstraction at Anthem/Elevance. HEDIS RN → Quality Coordinator/SME for HEDIS/CMS → HEDIS Lead. Excellent.

LinkedIn Email Phone

Work Experience

Elevance Health

HEDIS Coordinator · 3 years 1 month

Elevance Health

HEDIS Lead · 1 year 6 months

The Sullivan Centre

R.N. · 1 year

Riverside Radiology & Interventional Associates

R.N. · 2 years 11 months

+ 2 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

r cms education clinical abstraction emr liaison responsible home infusion

100%

J L

2019 and 2020 CMS 5 STARS Health Plan Quality Improvement Manager/ NCQA PCMH Certified Consultant/PCMH Project Manager

United States 18 years

Excellent fit - experienced manager focused specifically on healthcare quality improvement using HEDIS, STARS, and NCQA standards. Quality Improvement Manager at Cigna-HealthSpring managing HEDIS and STARS programs. Excellent.

LinkedIn Email Phone

Work Experience

Health Choice Network

Patient Centered Medical Home (PCMH) Project Director · 4 years

Preferred Care Partners

Skilled Nursing Case Manager · 1 year 6 months

Cigna-HealthSpring

Quality Improvement Manager

Health Choice Network

Director of Nursing Services/Case Mangement · 4 years

+ 1 more positions

Qualification Criteria 3 met, 1 not

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

healthcare cms management risk medicare medicaid health compliance completion projects responsible analysis +8 more

100%

N F

Clinical Quality Consultant

West Lebanon, Indiana, United States 10 years 9 months

Excellent fit - Registered Nurse who is currently working as a Clinical Quality Consultant and explicitly names HEDIS skills alongside Medicaid/Medicare quality program management. Registered Nurse → Quality Management Coordinator → Clinical Quality Consultant handling HEDIS. Excellent.

LinkedIn Email Phone

Work Experience

Unity Healthcare, LLC

Quality Management Coordinator · 4 years 3 months

Optum

Clinical Quality Consultant

Indiana University Health

Registered Nurse · 7 months

Presence Health

Registered Nurse · 1 year 9 months

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

microsoft applications medicare advantage data analysis quality management clinical microsoft physicians commercial medicare medicaid risk education +8 more

100%

A** J

HEDIS COORDINATOR at Health Net Supervising Quality Improvement Specialist

Tehachapi, California, United States 22 years 1 month

This candidate is an excellent match, currently working as a HEDIS Coordinator with extensive background in quality improvement and prior management/nursing roles. Health Net (HEDIS Coordinator, 7y 10m) → Kelly Services (HEDIS Abstractor, 2y 2m) → Prior Bedside Nursing (15 years). Excellent.

LinkedIn Email Phone

Work Experience

Providence St Joseph Medical Center

Staff RN · 1 year

Northridge Hospital Medical Center

Staff RN · 2 years

UHS

RN, IBCLC · 7 years 4 months

Health Net

HEDIS COORDINATOR · 7 years 10 months

+ 5 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

nursing cerner meditech health administration receiving humanitarian creative clinical troubleshooting analysis patient care +1 more

100%

C E

LPN, CPC, CRC, COC, CPMA

New York City Metropolitan Area, United States 10 years 6 months

Excellent fit, this candidate worked extensively as a Quality Practice Advisor specifically coding charts according to HEDIS measures and abstracting data. Quality Practice Advisor (8+ yrs focusing on HEDIS/QARR) → Quality Management Coordinator (HEDIS/QARR), LPN/CPC/CRC/COC certified. Excellent.

LinkedIn Email Phone

Work Experience

Comprehensive Health Management

Quality Practice Advisor · 8 years 7 months

Pathway Medical

HEDIS Nurse Reviewer · 4 months

MedAssurant

Nurse Chart Reviewer · 1 year 1 month

Amerigroup Community Care

Quality Management Coordinator · 1 year 1 month

Qualification Criteria 3 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

remote access office management quality improvement quality assurance medical records quality management risk management case management disease management patient care compliance specifications +8 more

100%

L T

2025 Adaptive CrossFit Games Fittest on Earth Manager EHR Data and Population Health Analytics at Independence Blue Cross

Coatesville, Pennsylvania, United States 16 years

Excellent fit demonstrated by current role managing population health analytics including explicit HEDIS/Stars mentions. Manager EHR Data/Population Health Analytics → Manager, Population Health at Independence Blue Cross - expertise in HEDIS, Stars, data analysis. Manager EHR data and Population Health Analytics → Manager, Population Health. Excellent.

LinkedIn Email Phone

Work Experience

Shippensburg University

Student Athletic Trainer · 3 years 5 months

The Hill at Whitemarsh

Fitness and Wellness Coordinator · 2 years 2 months

Shippensburg Health Care Center

Certified Nursing Assistant · 1 year 9 months

FSC Field Hockey Club

Coach · 3 years 9 months

+ 6 more positions

Qualification Criteria 3 met, 1 not

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

crossfit health insurance cms analysis reporting clinical management administration technology analytics trainer +8 more

100%

E W

Sr Program Manager at Blue Cross NC

Raleigh, North Carolina, United States 16 years 5 months

This candidate is an excellent match combining three years of direct HEDIS experience with a Registered Nurse background and quality management roles. Sr Project Manager HEDIS → Nurse, BS/MS in Nursing/Health Admin. Excellent.

LinkedIn Email Phone

Work Experience

DURHAM COUNTY HEALTH DEPARTMENT

BCCCP (Breast and Cervical Cancer Control Program) Navigator · 1 year 6 months

Blue Cross NC

Quality Management Consultant · 2 years 9 months

Atrium Health

Bedside Nurse (L&D/OB Triage) · 7 years 8 months

WakeMed

Ambulatory Care Nurse · 4 months

+ 3 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

cancer management triage ambulatory planning quality management ambulatory care

100%

A** N*

MBA, BSN, RN, CPHQ, Lean Green Belt Healthcare Quality Improvement Manager with TMF Health Quality Institute

Tulsa, Oklahoma, United States 22 years 1 month

This person meets every criterion with strong recent experience in quality improvement/management using their RN background. Quality Analyst is covered by Quality Improvement Manager/Specialist roles, RN is yes, HEDIS experience is implied by Quality Improvement/CMS work, Healthcare quality is yes. Emergency Medicine RN → Quality Improvement Specialist → Quality Improvement Manager, BSN, RN, CPHQ, Lean Green Belt. Excellent.

LinkedIn Email Phone

Work Experience

OSU Medical Center

Discharge Liaison · 1 year 2 months

OSU Medical Center

BSN, RN Critical Care Coordinator · 2 years

TMF Health Quality Institute

Quality Improvement Specialist IV · 8 years 2 months

MSN Medical Staffing Network

RN · 2 years 1 month

+ 6 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

management healthcare efficiency cms liaison director abstraction inpatient reporting pain accreditation icu +8 more

100%

W P

HEDIS Program Manager at Highmark Wholecare

Garland, Texas, United States 30 years 9 months

This candidate is an excellent match, holding a recent role as a HEDIS Program Manager with extensive experience managing the entire HEDIS reporting lifecycle, demonstrating all required skills (though they don't list RN credentials, the job title indicates the necessary functional expertise). HEDIS Project Manager → National HEDIS Project Manager. Excellent.

LinkedIn Email Phone

Work Experience

Fidelity Investments

Retirement specialist · 2 years

Neighborhood Health Partnership/Perot Systems

Hedis Project Manager · 6 years 9 months

CarePlus Health Plan

HEDIS Project Manager · 2 years 9 months

Highmark Wholecare

HEDIS Program Manager · 7 years

+ 1 more positions

Qualification Criteria 3 met, 1 not

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

management retirement production health reporting clinical cms compliance finish education server sybase +8 more

100%

B C

Clinical Quality Analyst, SR

Chattanooga, Tennessee, United States 46 years 6 months

This candidate is a perfect match, having served 27+ years in clinical/HEDIS quality roles, including manager and analyst positions, along with nursing experience. Clinical Quality Analyst/HEDIS Manager for 20+ years, prior Field Review Nurse experience. Excellent.

LinkedIn Email Phone

Work Experience

UnitedHealth Group

HEDIS Clinical Quality Manager · 8 years 9 months

UW Health

Float Nurse - TLC, Cardiology, Ortho, Gen Med/Surgery, Oncology, Pediatrics · 5 years

EDS (Wisconsin HIRSP)

Utilization Review Nurse/Prior Authorization Appeals · 3 years 5 months

Dean Clinic

Float Nurse - Internal Medicine, OB, Urgent Care, Pediatrics, Geriatrics, Oncology · 3 years 1 month

+ 6 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

clinical tlc cardiology surgery oncology pediatrics appeals geriatrics health phlebotomy accident chemicals +8 more

100%

D A

Director, Quality and Regulatory

Richmond, Virginia, United States 12 years 7 months

This director has explicit oversight and management of all HEDIS operations, fulfills the quality analyst oversight function, and works in healthcare quality leadership. Director, Quality and Regulatory, Sentara Health/Virginia Premier. Excellent.

LinkedIn Email Phone

Work Experience

Anthem, Inc. Government Business Division

Manager II, Quality Management · 4 years 7 months

Sentara Health/ formerly Virginia Premier

Director, Quality and Regulatory · 8 years 2 months

Qualification Criteria 3 met, 1 not

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

director clinical reports accountability operations projects budget health management strategy training recruitment +8 more

100%

M K

Clinical Informatics Manager at Iowa Health Plus

West Des Moines, Iowa, United States 18 years

Excellent fit - this candidate managed quality operations and explicitly developed HEDIS processes and mentored abstractors. Clinical Informatics Manager → Manager: Quality Management (Developed HEDIS process) → Quality Management Consultant. Excellent.

LinkedIn Email Phone

Work Experience

Iowa Primary Care Association

Clinical Informatics Manager

Amerigroup

Manager: Quality Managent · 1 year 10 months

Mercy Medical Center Des Moines, IA

Cardio/ Pulmonary Nurse · 5 years 1 month

Wellmark

Quality Management Consultant · 4 years

Qualification Criteria 3 met, 1 not

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

quality management data governance data collection data analysis management accreditation spark collaboration clinical informatics emr claims +8 more

100%

A L

Health Plan Quality, HEDIS

Dallas, Texas, United States 10 years 5 months

Excellent fit with recent management and director roles explicitly focused on Health Plan Quality and HEDIS within healthcare organizations. Experience includes HEDIS Quality Director and Manager, Health Plan Quality roles at Molina and CHRISTUS Health. QA Analyst (Yes, managerial level) → Nurse / RN (No) → HEDIS experience (Yes) → Healthcare quality (Yes). Excellent.

LinkedIn Email Phone

Work Experience

Molina Healthcare

Manager, Quality Interventions · 4 months

WellMed Medical Management

HEDIS Quality Manager · 1 year 9 months

Intrepid USA Healthcare Services

Administrator · 1 year 9 months

WellMed Medical Management

Senior Clinical Quality Consultant · 5 years

+ 5 more positions

Qualification Criteria 3 met, 1 not

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

healthcare leadership interventions clinical director health accounting responsible training coaching counseling compliance +7 more

100%

S D

Quality Management, Project Manager

New Orleans, Louisiana, United States 30 years 10 months

This candidate is a doctoral-prepared advanced practice nurse with specific experience managing quality initiatives, policy development, and quality/safety metrics, fitting all criteria perfectly including prior triage nurse work. Quality Manager/Project Manager → Clinical Triage Nurse, advanced practice doctorate in nursing. Excellent.

LinkedIn Email Phone

Work Experience

Humana Health Benefit Plan of Louisiana

Clinical Advisor | Quality Management

Ochsner Health

Project Manager (System) Center of Quality Excellence and Patient Safety | Ambulatory Care

Aetna Inc.

Regional Project Manager

Ochsner Health

Ambulatory Quality Improvement Coordinator | System Quality

+ 3 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

patient safety regulatory compliance staff development ambulatory care quality management record keeping project manager project management case management utilization management quality improvement quality assurance +8 more

100%

A S

Certified Case Manager, Quality Care Consultant, HEDIS Specialist

Carrollton, Texas, United States 16 years 1 month

This candidate profile directly mentions RN credentials, HEDIS specialization, and quality audit collaboration. RN, MSN, CCM → Molina Healthcare Case Management/Quality, explicit HEDIS/QA experience. Excellent.

LinkedIn Email Phone

Work Experience

WellMed Medical Management

LVN Quality Coordinator · 1 year

Molina Healthcare

Specialist, Quality Interventions/QI Compliance · 4 years

WellMed Medical Management

RN Clinical Quality Consultant, II · 1 year

IntegraNet Health

RN Contract HEDIS/GPRO Chart Reviwer · 5 months

+ 5 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

coordination management collaboration interventions interpreting clinical insurance accreditation software microsoft salesforce nextgen +8 more

100%

K B**

Nurse Clinical Quality Professional | Healthcare Business Outcomes Advanced Analytics | HEDIS/STARS | CAHPS | Entrepreneur & Co-Owner LazyKRanch.Kitchen private fine dining & event venue coming soon in 2025.

Pauls Valley, Oklahoma, United States 17 years 10 months

This candidate is an excellent match, explicitly holding the title of HEDIS Manager and mentioning STARS/CAHPS alongside RN clinical quality experience. Ex-Peterson → Anthem (HEDIS Manager 7+ yrs). Excellent.

LinkedIn Email Phone

Work Experience

Anthem, Inc.

Clinicql Quality Program Manager · 2 years

MSN Homecare

RN Case Manager/Alternate Administrator · 2 years 3 months

Elevance Health

Advanced Execution Lead · 1 year 8 months

Kiser Healthcare Solutions, LLC

Quality Consultant · 11 months

+ 6 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

quality management data analytics strategy development change leadership communication skills sales manager quality improvement healthcare agility management analytics strategy +8 more

100%

H B

Senior Director for Supplemental Data Processes at WellMed Medical Management

Pompano Beach, Florida, United States 25 years 9 months

Strong executive director background highlighting proven RN experience combined with specific expertise in Quality Improvement, NCQA, and HEDIS measures. Senior Director at WellMed Medical Management, RN background, extensive Quality Improvement/HEDIS leadership. Strong.

LinkedIn Email Phone

Work Experience

Health Dialog

Senior Director, Operation Call Centers · 6 years

Health Dialog

Senior Director, Provider Product · 2 years

Sunshine Health

Vice President, Quality Improvement · 2 years 1 month

UPMC Health Plan

Director, Quality Improvement · 6 years

+ 3 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

results oriented health insurance quality improvement home care intensive care operating room change management decision support business process child welfare call centers case management +8 more

98%

D E

Registered Nurse

Atlanta, Georgia, United States 20 years 3 months

Exceptional fit with current RN background and deep recent history managing HEDIS projects across multiple organizations, citing explicit HEDIS/STARS expertise in the summary. Manager, HEDIS (5.5 years) → HEDIS Consultant → Associate Director- HEDIS Clinical Review, background as RN. Excellent.

LinkedIn Email Phone

Work Experience

IU Health Plans

HEDIS Consultant · 1 year

Q-Centrix

Senior Abstraction Specialist · 1 year 6 months

Sonder Health Plans

Director of Quality Management · 6 months

UnitedHealth Group

Associate Director- HEDIS Clinical Review · 2 years 3 months

+ 6 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

managed care best practices quality management critical care hipaa compliance health education training clinical healthcare abstraction +3 more

95%

A B

Healthcare Quality and Compliance Expert | Quality Improvement Manager | HEDIS & CAHPS | Continuous Quality Improvement

Salt Lake City, Utah, United States 20 years 1 month

This candidate is a strong fit with extensive experience managing quality improvement, compliance, and specific mention of HEDIS and NCQA preparation. Quality Improvement Manager/Specialist roles for 20+ years, focused on HEDIS/CAHPS. Excellent.

LinkedIn Email Phone

Work Experience

Molina Healthcare

Quality Improvement Coordinator · 7 months

Salt Lake Valley Health Department

Gold Medal Schools Mentor · 11 months

Molina Healthcare

Administrative Project Coordinator · 6 months

Molina Healthcare

Program Manager · 6 years 3 months

+ 2 more positions

Qualification Criteria 3 met, 1 not

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

management preparation planning accreditation audit projects abstraction coordination vendor gold compliance quality improvement +5 more

95%

L H

Medicare Stars Director at Aetna, a CVS Health Company

Truckee, California, United States 17 years 6 months

This candidate is a strong fit with extensive quality and nursing management experience, including specific HEDIS work. Ex-Aetna Medicare Stars Director → Sr. Mgr Value Based Ops → Sr. Clinical Strategist, total 17+ years. Excellent.

LinkedIn Email Phone

Work Experience

Childrens Hospital Oakland

Registered Nurse - NICU · 1 year

Community Memorial Hospital of Ventura

Registered Nurse - NICU · 5 years

Aetna, a CVS Health Company

Sr. Mgr Business Consulting, Value Based Operations · 1 year 7 months

Inovalon

Site Review Consultant · 6 months

+ 4 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

managed care project management strategic planning quality improvement data analytics intensive care system development production support risk management medical records critical thinking business requirements +8 more

95%

G O

Healthcare Quality Professional | Peer Review Coordinator at CIMRO | MPH | 10+ Years in QI & Data Analysis

Champaign, Illinois, United States 17 years 10 months

This candidate has substantial experience as a Quality Coordinator with a direct focus on improving HEDIS rates across multiple measures. Ex-CVS Health → CIMRO → Carle Health → Health Alliance Medical Plans, 17+ years total experience. Excellent.

LinkedIn Email Phone

Work Experience

OSF HealthCare

Healthcare Navigator · 2 years

Walmart

Customer Service Supervisor · 2 years 6 months

CIMRO Quality Healthcare Solutions

Review Coordinator · 7 months

University of Illinois at Urbana-Champaign

Student Supervisor · 2 years 10 months

+ 5 more positions

Qualification Criteria 3 met, 1 not

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

health management rates weight assessment cancer screening healthcare risk coordination insurance consultation +8 more

95%

S G

RN, BSN, CPC-A

Minneapolis, Minnesota, United States 14 years 6 months

This candidate has significant recent and extensive experience as a HEDIS Lead RNA and HEDIS Quality Nurse, clearly fitting the role profile while maintaining RN credentials. RN/CPC-A → UM Nurse → HEDIS Quality Nurse @ Humana → HEDIS Lead @ Elevance. Excellent.

LinkedIn Email Phone

Work Experience

Humana

Front Line leader for UM acute · 6 months

Centene Corporation

Quality Program Development Manager · 1 year 9 months

Humana

UM Nurse · 1 year 2 months

CentraCare Health

Clinical Liaison · 11 months

+ 6 more positions

Qualification Criteria 4 met

Nurse / RN

Quality Analyst

HEDIS experience

Healthcare quality

Skills & Expertise

healthcare clinical liaison education cms documentation insurance less healthcare industry program development project manager provider relations

Candidate Profiles

L*** G****

Work Experience

Qualification Criteria 4 met

Skills & Expertise

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Work Experience

Qualification Criteria 4 met

Skills & Expertise

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Work Experience

Qualification Criteria 4 met

Skills & Expertise

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Work Experience

Qualification Criteria 3 met

Skills & Expertise

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Work Experience

Qualification Criteria 4 met

Skills & Expertise

D**** S****

Work Experience

Qualification Criteria 3 met, 1 not

Skills & Expertise

W**** L**

Work Experience

Qualification Criteria 3 met, 1 not

Skills & Expertise

B**** C****

Work Experience

Qualification Criteria 4 met

Skills & Expertise

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Work Experience

Qualification Criteria 4 met

Skills & Expertise

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Work Experience

Qualification Criteria 3 met, 1 not

Skills & Expertise

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Work Experience

Qualification Criteria 4 met

Skills & Expertise

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Work Experience

Qualification Criteria 4 met

Skills & Expertise

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Work Experience

Qualification Criteria 3 met

Skills & Expertise

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Work Experience

Qualification Criteria 3 met, 1 not

Skills & Expertise

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Work Experience

Qualification Criteria 4 met

Skills & Expertise

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Work Experience

Qualification Criteria 4 met

Skills & Expertise

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Work Experience

Qualification Criteria 3 met, 1 not

Skills & Expertise

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Work Experience

Qualification Criteria 4 met

Skills & Expertise

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Work Experience

Qualification Criteria 3 met, 1 not

Skills & Expertise

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Work Experience

Qualification Criteria 3 met, 1 not

L* G**

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