• Lead Abstractor, HEDIS /Quality…

    Molina Healthcare (Paducah, KY)
    …Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. + Mentor entry and Sr. level abstractors. + Works ... HEDIS like projects and supplemental data collection. The lead abstraction team will meet chart abstraction productivity standards,... role in the coordination and preparation of the HEDIS medical record review which includes ongoing… more
    Molina Healthcare (10/25/24)
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  • Sr Analyst, HEDIS /Quality Reporting…

    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
    Molina Healthcare (10/20/24)
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  • HEDIS Registered Nurse or LPNs (Field…

    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
    Insight Global (10/01/24)
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  • Remote HEDIS - Quality Improvement…

    Actalent (Atlanta, GA)
    …results to HEDIS standards and/or custom or other measure set standards * Review medical records and abstract data for HEDIS and other measure sets in ... Description: Position Purpose: Lead data collection and abstraction for company quality...data collection and abstraction for company quality measures, including HEDIS , CMS, CHIPRA and/or any other custom measurements. Responsibilities:… more
    Actalent (11/05/24)
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  • Quality Improvement (RN) - Maternity (OB/GYN)

    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 (10/20/24)
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  • Sr Medical Records Collector - Remote (PST)

    Molina Healthcare (Long Beach, CA)
    …national and/or regional lead , the Medical Records Collector supports the annual HEDIS audit and other HEDIS like audits, by organizing provider outreach, ... collecting medical records and reports from provider offices, loads data into the HEDIS application. + Assists the manager/ lead and quality improvement staff… more
    Molina Healthcare (09/06/24)
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  • Quality Review Abstractor

    Dignity Health (Phoenix, AZ)
    …leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health's Medicaid population health care management ... medical records (paper and electronic) to ensure compliance with quality measures like HEDIS . This role involves making outreach calls and texts to assist members in… more
    Dignity Health (10/25/24)
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  • Lead Analyst, Data Quality Analytics…

    Molina Healthcare (OH)
    …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
    Molina Healthcare (11/07/24)
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  • Medicare Provider Performance Enablement…

    The Cigna Group (Seattle, WA)
    **Role Summary:** The Provider Performance Lead Analyst is a key member of the market that assists in the growth and development of the provider network. The Lead ... and the individual that represents Cigna MA. The Provider Performance Lead Analyst's responsibilities include: + Supporting the development, management and oversight… more
    The Cigna Group (10/26/24)
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  • CenterWell Physician Lead

    CenterWell (Jackson, MS)
    …do. Our Clinics offer a team-based care model where our physicians lead a multi-disciplinary care team supporting patient's physical, emotional, and social wellness. ... those in the communities we serve, including our associates, lead their best lives. We support our associates in...inquiries, requests, and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality… more
    CenterWell (10/30/24)
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  • Lead Medical Support Assistant

    Veterans Affairs, Veterans Health Administration (Hampton, VA)
    …functions as a key member of the Health Administration Service (HAS). The Lead Medical Support Assistant (MSA) serves as direct support to the Supervisory MSA ... Primary Care, Specialty Care, Mental Health, Inpatient and Outpatient Clinics. The Lead MSA provides comprehensive, detailed, and on-the-job training to all new… more
    Veterans Affairs, Veterans Health Administration (10/30/24)
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  • Medicare Provider Performance Enablement…

    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
    The Cigna Group (10/03/24)
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  • Lead Data Scientist/Engineer

    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
    Insight Global (08/13/24)
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  • Quality Improvement Abstractor

    Centene Corporation (Columbia, SC)
    …results to HEDIS standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS and other measure sets in ... benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Lead data collection and abstraction for company quality measures, including … more
    Centene Corporation (09/01/24)
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  • Senior Manager, Practice Innovation

    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
    University of Virginia (11/07/24)
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  • Data Analyst III - Healthcare Analytics

    Centene Corporation (Jefferson City, MO)
    …needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. + Provide advanced analytical support for business operations in ... of the following areas: claims, provider data, member data, clinical data, HEDIS , pharmacy, external reporting + Extract, load, model, and reconcile large amounts… more
    Centene Corporation (11/06/24)
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  • Medicaid Quality Management Director

    Elevance Health (Buffalo, NY)
    …in developing, monitoring, and evaluating Healthcare Effectiveness Data Information Set ( HEDIS ) improvement action plans, year-round medical record review , and ... of quality management to direct the clinical quality initiatives, including HEDIS and CAHPS quality improvement, NCQA accreditation and compliance with regulatory… more
    Elevance Health (10/25/24)
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  • Primary Care Physician

    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
    ChenMed (09/28/24)
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  • Public Health Educator/Senior Strategist

    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
    ERP International (09/17/24)
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  • VP, Medical Management

    Somatus (Mclean, VA)
    …care. + Participates in pharmacy utilization management, case reviews, outreach programs, HEDIS reporting, nutrition service review , and health plan and provider ... to): multi-payer total cost of care ($PMPM) management, NCQA HEDIS quality measures, etc. + Serve as a clinical...at medical group meetings, conferences, etc. as appropriate. + Lead and attract top talent, motivate, assess, and manage… more
    Somatus (10/13/24)
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