• Senior HEDIS Medicaid Data Manager

    Humana (Columbus, OH)
    …of variable factors. Humana's Health Quality and Stars organization is seeking a Senior HEDIS Data Manager to deliver quality and value in a fast-paced, dynamic ... and help us put health first** The Senior Data Manager supports all aspects of configuration control, data management,...with partners across the enterprise and support of the HEDIS program and related activities. This will require building… more
    Humana (11/22/24)
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  • Medical Records Collector (Must reside near…

    Molina Healthcare (ID)
    …pursuit and collection of medical records and other data in collaboration with other HEDIS staff. * Assists the Manager and Supervisor(s) and / or performs ... **JOB DESCRIPTION** **Job Summary** Molina's HEDIS /Quality Improvement Medical Records Collector will work collaboratively...system retrieval and direct onsite pick up, for the HEDIS projects. **Job Duties** * Under the direction of… more
    Molina Healthcare (11/16/24)
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  • Business Information Developer Consultant…

    Elevance Health (St. Louis, MO)
    **Business Information Developer Consultant - HEDIS Analytics** **Location:** This position will work a hybrid model (remote and in office one to two days per week). ... Wallingford, CT or Louisville, KY. The **Business Information Developer Consultant - HEDIS Analytics** is responsible for developing and executing more complex data… more
    Elevance Health (10/29/24)
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  • Sr Analyst, HEDIS /Quality Reporting…

    Molina Healthcare (MI)
    …compliance activities. **Candidates residing in Michigan with SQL, Quality/ HEDIS and Health plan experience are strongly preferred.** **KNOWLEDGE/SKILLS/ABILITIES** ... In collaboration with Quality Improvement (QI) management, the Senior Analyst, HEDIS /Quality Reporting develops and provides reports and cost-benefit analysis tools… more
    Molina Healthcare (10/20/24)
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  • HEDIS Research Analyst

    Elevance Health (Miami, FL)
    …workplace model with PulsePoint sites used for collaboration, community, and connection The ** HEDIS Research Analyst** is responsible for serving as an expert in ... HEDIS data analysis, reporting and formulating recommendations, and providing...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (11/22/24)
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  • Quality Improvement (RN) - Maternity (OB/GYN)

    Molina Healthcare (Ypsilanti, MI)
    …of these quality improvements functions: Quality Interventions, Quality Improvement Compliance, HEDIS , and / or Quality Reporting. Quality Intervention / QI ... expertise is important to the activity. + Surfaces to Manager and Director any gaps in processes that may...would be valuable to uncover process gaps or limitations. HEDIS / Quality Reporting + Performs the lead role… more
    Molina Healthcare (10/20/24)
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  • Senior Medical Management Nurse - VCHCP

    Ventura County (Ventura, CA)
    …Utilization Management and tasks related to Healthcare Effectiveness Data and Information Set ( HEDIS ) as well as writing reports and analyses in line with the ... complex cases, disease managing certain populations, performing utilization reviews, supervising HEDIS documentation, and writing required analyses to meet or align… more
    Ventura County (11/12/24)
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  • Program Manager II - Healthcare

    Centene Corporation (Richmond, VA)
    …experience preferred. **Position Purpose:** Coordinate with teams to ensure HEDIS data accuracy and reporting, including investigations, auditing, and improvement ... opportunities. Collaborate with internal and external stakeholders to ensure HEDIS and CAHPS initiatives are fully integrated throughout the organization, maximizing… more
    Centene Corporation (11/23/24)
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  • Clinical Quality Program Manager III

    LA Care Health Plan (Los Angeles, CA)
    Clinical Quality Program Manager III Job Category: Clinical Department: Quality Improvement Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... required to achieve that purpose. Job Summary The Clinical Quality Program Manager is responsible for identifying, implementing, and guiding projects relating to… more
    LA Care Health Plan (11/07/24)
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  • Manager , Clinical Quality Analytics

    LA Care Health Plan (Los Angeles, CA)
    Manager , Clinical Quality Analytics Job Category: Clinical Department: Quality Improvement Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... support the safety net required to achieve that purpose. Job Summary The Manager of Clinical Quality Analytics (MSA) is responsible for the operations, projects and… more
    LA Care Health Plan (08/28/24)
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  • Senior Manager , Practice Innovation

    University of Virginia (Charlottesville, VA)
    …to develop relevant in-person and online educational trainings on priority HEDIS quality measures, complex diagnosis documentation for improved risk adjustment, and ... quality metric performance. + Maintains thorough knowledge and understanding of the HEDIS quality measures, their nuances and the specifications to adequately speak… more
    University of Virginia (11/07/24)
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  • VBC Program Manager WFH

    HCA Healthcare (Nashville, TN)
    …Do you want to join an organization that invests in you as a VBC Program Manager WFH? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 ... difference. We are looking for a dedicated VBC Program Manager WFH like you to be a part of...Organizations (ACO); Advanced Alternative Payment Models; Medicare Advantage including HEDIS ; and commercial payer value programs. Oversight is all… more
    HCA Healthcare (11/13/24)
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  • Clinic Manager - North Buckner

    CenterWell (Dallas, TX)
    …CenterWell is a subsidiary of Humana, seeking a Primary Care Clinic Manager , that develops and leads implementation for staffing plans, policies and procedures ... patient outcomes and company initiatives including but not limited to Quality, HEDIS / STARs, AHCA, financial management and employee and patient retention. Must… more
    CenterWell (11/19/24)
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  • Clinical Quality Program Manager

    Elevance Health (Miami, FL)
    **JR131500 Clinical Quality Program Manager ** Responsible for serving as a liaison with and overseeing the quality improvement activities/projects/programs for one ... will you make an impact:** + Leads plan level HEDIS strategy to drive improvement in behavioral health ...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (11/16/24)
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  • Risk & Quality Performance Manager (Remote)

    Molina Healthcare (NE)
    **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success. * Partner with other teams to ensure data quality… more
    Molina Healthcare (11/23/24)
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  • Lead Risk & Quality Performance Manager

    Molina Healthcare (UT)
    **Job Description** **Job Summary** The Lead Risk and Quality Performance Manager supports Molina's Risk & Quality Solutions (RQS) team by overseeing large programs ... initiatives in alignment with RQS's strategic objectives. **Experience working with HEDIS Data to find opportunities for improvement is important for this… more
    Molina Healthcare (11/07/24)
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  • Provider Engagement Account Manager

    Centene Corporation (Tallahassee, FL)
    …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization. **Drivers License required** Pay Range: $54,000.00 -… more
    Centene Corporation (11/23/24)
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  • Quality Improvement Manager

    Praxis Health (OR)
    …you on our team! What You'll Do: + Lead and manage a team of HEDIS reviewers with clear goals and performance metrics. + Develop and implement quality improvement ... Serve as the key liaison between Praxis and payer partners. + Provide training on HEDIS measures and best practices to clinic leaders and staff. + Host internal and… more
    Praxis Health (11/20/24)
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  • LPN or RN Nurse Case Manager (Onsite…

    The Cigna Group (Bloomfield, CT)
    …manage relationships with participating provider practices. Maintain detailed understanding of HEDIS / STAR performance measures. Develop and maintain a process to ... utilization management position (experience can be a combination of LVN/RN licensure) + Previous HEDIS and/or CMS STARs experience a plus. If you will be working at… more
    The Cigna Group (10/10/24)
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  • Quality Improvement Professional

    CenterWell (Raleigh, NC)
    …and develop practice specific strategies designed to improve Medicare quality measures ( HEDIS ) as well as Part D/Patient Safety and Patient Experience (CAHPS-HOS). ... that will positively impact improved outcomes for CMS Stars quality measure ( HEDIS , patient safety and patient satisfaction).** **Provide support at all levels for… more
    CenterWell (11/21/24)
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