- Molina Healthcare (MI)
- …Improvement functions (eg, reporting for key performance measurement activities, including HEDIS , state-based measure reporting and medical record review ). + ... QI compliance activities. **Candidates residing in Michigan with SQL, Quality/ HEDIS and Health plan experience are strongly preferred.** **KNOWLEDGE/SKILLS/ABILITIES**… more
- Actalent (Austin, TX)
- Actalent is currently hiring for Remote HEDIS Nurses (RN/LPN)! Job Description: + Lead data collection and abstraction for company quality measures, including ... standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS and other measure sets in compliance with standards +… more
- Actalent (Austin, TX)
- …CMS, and CHIPRA * Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom * Review medical records and abstract data ... Job Description * Lead data collection and abstraction for company quality...vendors Additional Skills & Qualifications * Recent experience with HEDIS , NCQA, Quality Initiatives/Standards. * Previous HEDIS … more
- Insight Global (Philadelphia, PA)
- …) Strong computer skills Ability to occasionally travel to local providers Previous HEDIS review experience or experience with Utilization Review , Quality, ... Description A client of Insight Globals is looking for HEDIS RNs or LPNs for a partially remote contract...entry of medical records assigned by a Clinical Quality Lead nurse. Miles will be reimbursed for any travel.… more
- Actalent (Philadelphia, PA)
- Remote HEDIS LPN Abstractor Description: Position Purpose: Lead data collection and abstraction for company quality measures, including HEDIS , CMS, CHIPRA ... standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS and other measure sets in compliance with standards +… more
- Molina Healthcare (WI)
- …in healthcare quality data. + 4+ Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking, Interventions tracking for at ... **Job Description** **Job Summary** The Lead Analyst, Quality Analytics and Performance Improvement role...Analytics team. Designs and develops reporting solutions to assist HEDIS audit, rate tracking, and Identifying targeted Interventions and… more
- Molina Healthcare (Ypsilanti, MI)
- …where a clinician's perspective would be valuable to uncover process gaps or limitations. HEDIS / Quality Reporting + Performs the lead role in the coordination ... Quality Intervention / QI Compliance + Acts as a lead specialist to provide project-, program-, and / or...and preparation of the HEDIS medical record review… more
- Molina Healthcare (MI)
- …member and provider outreach. + Serves as operations subject matter expert and lead for Molina Plan quality improvement HEDIS operations using a defined ... implementation, monitoring, and oversight of all chart collection for HEDIS , or HEDIS -like projects, Risk Adjustment, Risk...effective operations that drive change. + Functions as key lead for clinical chart review /abstraction and team… more
- Molina Healthcare (ID)
- …in healthcare quality data. + 5+ Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking, Interventions tracking for at ... + 5+ Years of experience in Statistical Analysis and forecasting of trends in HEDIS rates to provide analytic support for quality, finance, and health plan functions… more
- CenterWell (Raleigh, NC)
- …and approved workflow and leaders as needed. Follows established guidelines/procedures.** ** Review and assess provider/member detail HEDIS data (care gap ... and develop practice specific strategies designed to improve Medicare quality measures ( HEDIS ) as well as Part D/Patient Safety and Patient Experience (CAHPS-HOS).… more
- Veterans Affairs, Veterans Health Administration (Portsmouth, VA)
- Summary The Lead Medical Support Assistant position will be held within the Mental Health, Specialty and Primary Care in the Hampton VA Healthcare System located at ... Community Base Outpatient Clinic (CBOC) Responsibilities The incumbent serves as a Lead Medical Support Assistant in the Hampton VA Healthcare System. The incumbent… more
- Insight Global (Chicago, IL)
- Job Description The Lead Data Scientist/Engineer plays a pivotal role in supporting the Medicare Clinical Stars program by providing technical expertise in data ... support to enable data-driven insights for clinical stars initiatives. The Lead Data Engineer collaborates closely with data scientists, engineers, and stakeholders… more
- The Cigna Group (Sunrise, FL)
- **Role Summary** The Provider Performance Enablement Lead Analyst is a key member of the market that assists in the growth and development of the provider network. ... that represents Cigna Medicare Advantage. The Provider Performance Enablement Lead Analyst's responsibilities include: + Most likely to have responsibility… more
- University of Virginia (Charlottesville, VA)
- …optimizing workflows for capture of relevant clinical information. + Engage in periodic review of program data reflecting performance and outcomes. + Serve as team ... to develop relevant in-person and online educational trainings on priority HEDIS quality measures, complex diagnosis documentation for improved risk adjustment, and… more
- ChenMed (Philadelphia, PA)
- …and hospital sick days), CG CAHPS and net promoter score (patient experience), HEDIS and clinical gaps closures, and medical cost effectiveness measures. Each PCP ... accountability, and passion. As a player/coach, the SMD will demonstrate and lead the center's providers towards: Accountability and oversight for outcomes: The SMD… more
- ERP International (Camp Pendleton, CA)
- …Population Health Program, including strategic marketing for specific audiences. * Review beneficiary data from DHB and current and previous analytical data ... * Work with the COR and NHCP/NMRTC Camp Pendleton PHP Government Lead to ensure effective contract management, fulfillment of deliverables, and management of… more
- Molina Healthcare (NM)
- …of these quality improvements functions: Quality Interventions, Quality Improvement Compliance, HEDIS , and / or Quality Reporting. Quality Intervention / QI ... Compliance + Acts as a lead specialist to provide project-, program-, and / or...care); preparation for Quality Improvement Compliance surveys; preparation and review of potential quality of care and critical incident… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …and ensure adequate training is available for documentation and coding best practices for HEDIS and risk adjustment. This role will have a positive impact on our ... practices. Partner with Coding Quality Educators to identify opportunities to review providers' medical records to better understand knowledge and performance gaps… more
- Sharp HealthCare (San Diego, CA)
- …in risk management reviews. + Assists in pharmacy utilization management, catastrophic case review , outreach programs, HEDIS reporting, site visit review ... services, and oversees the health care needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its' Chief Medical Officer.… more
- ERP International (Nellis AFB, NV)
- …by using MTF specific Quality Improvement processes to identify areas for review from data, suspected problem areas, and input from departments/services within the ... and continually evaluates the impact of implementation. Incorporates applicable utilization review tasks to ensure patients receive the appropriate level of care… more