HEDIS Specialist (Behavioral Health)

Location: Remote-MO; must be authorized to work in the United States without current or future employment-based visa sponsorship

Salary: $56,200–$101,000 per year

Company

hirify.global provides healthcare services focused on connecting people with the care they need and improving health outcomes.

What you will do

• Develop and implement strategies to improve behavioral health HEDIS and Pay for Performance measures.
• Identify and close care gaps through targeted member interventions and clinical collaboration.
• Partner with health plans, regional clinical leadership, quality improvement, and medical management teams.
• Prepare financial impact and return-on-investment analyses for initiatives requiring additional resources.
• Monitor intervention effectiveness, provide education, and communicate outcomes to stakeholders.
• Analyze data and trends to identify quality and clinical improvement opportunities.

Requirements

• Bachelor’s degree in nursing, a related field, or equivalent experience.
• At least 3 years of case management or utilization management experience in a behavioral or physical healthcare setting.
• Knowledge of behavioral or physical health HEDIS and performance measures.
• Experience implementing interventions to improve HEDIS rates.
• Current unrestricted state license as an LCSW, LMFT, LPC, PhD, PsyD, or RN preferred.
• Must be authorized to work in the U.S. without employment-based visa sponsorship now or in the future.

Nice to have

• Supervisory or lead experience.

Culture & Benefits

• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Flexible work approach with remote, hybrid, field, or office schedules across the organization.
• Equal opportunity workplace committed to diversity and inclusion.