- Molina Healthcare (Florence, KY)
- …of the performance measurement data collection, reporting and monitoring process, including HEDIS , state-based measure reporting and medical record review . + ... surveys and federal/state QI compliance activities. **Job Duties** + The Mgr, Clinical Data Acquisition uses knowledge, skills and technical expertise to manage the… more
- Blue KC (MO)
- …financial assistance** **Employee discount program** **Job Description Summary:** The HEDIS Quality Performance Analyst RN provides clinical interpretation ... medical records for HEDIS (R) reporting. This position involves abstraction of clinical information from medical records that meet Hedis measure requirement… more
- Ventura County (Ventura, CA)
- …years of full-time experience in Case Management, Disease Management, Quality Assurance, HEDIS and/or Utilization Review . NECESSARY SPECIAL REQUIREMENTS + Must ... Utilization Management and tasks related to Healthcare Effectiveness Data and Information Set ( HEDIS ) as well as writing reports and analyses in line with the… more
- GEHA (Lee's Summit, MO)
- …Responsible for supervising the daily operations of the Care Management Department clinical programs and processes. Serves as the primary contact for staff, assigned ... and external programs, and escalated care management issues. Assists Administrator/ Manager with developing Care Management and utilization policies and procedures.… more
- Fallon Health (Worcester, MA)
- …Healthcare Effectiveness Data and Information Set ( HEDIS (R)) and MassHealth Appendix Q review . The clinical nurse analyst will provide clinical expertise ... and LinkedIn. **Brief summary of purpose:** Under the general direction of the Senior Manager , Clinical Quality, the clinical nurse analyst is responsible… more
- Fallon Health (Berkshire, MA)
- …rated among the nation's top health plans for member experience, service, and clinical quality. Fallon Health's NaviCare is a program for people age 65 and ... and LinkedIn** **Brief Summary of Purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary...providers and office staff and may lead care plan review with providers and care team as applicable +… more
- Penn Medicine (Bala Cynwyd, PA)
- …improving workplace safety in the practices. + Responsible for the creation, review , revision and communication of clinical /safety related policies. + Performs ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- Tufts Medicine (Burlington, MA)
- …business experience. 2. Four (4) years of healthcare management or clinic manager experience working directly with physicians and practice members with a ... in primary care. 2. Experience with and knowledge of HCC/RAF, PCMH, HEDIS /Quality. **Duties and Responsibilities:** The duties and responsibilities listed below are… 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 ... center, as the true dyad partner to the Center Manager /Center General Manager . Directly supervise, performance manage...VIP service, standards of care and quality guidelines, and HEDIS /STARS + Inspire seamless coverage of clinical … more
- ERP International (Camp Pendleton, CA)
- …communication strategies. * Collaborate with the Healthcare Effectiveness Data and Information Set ( HEDIS ) Clinical Quality Teams on a monthly basis to evaluate ... Population Health Program, including strategic marketing for specific audiences. * Review beneficiary data from DHB and current and previous analytical data… more
- Sea Mar Community Health Centers (Aberdeen, WA)
- …all relative clinic forms, quality/ HEDIS measures, lab and x-ray reports and review of the Patient Manager and Medication confirmation process and any ... month program that prepares students to take the Certified Clinical Medical Assistant (CCMA) test through the National Health...non-compliance should be reported immediately to the supervisor / manager . + Assists providers with GYN exams, I &… more
- CVS Health (Woodland Hills, CA)
- …These education sessions will engage and educate providers in understanding EES, HEDIS , improving measure results, closing gaps in care, and more. + Support ... Health Equity (HE)/Culturally and linguistically appropriate services (CLAS) program activities. Review , plan, and implement activities within the HE work plan to… more
- Centene Corporation (Tallahassee, FL)
- …focused on improvement in pharmacy quality measures (Part D Patient Safety Measures, HEDIS , PQA, etc.), and drug utilization review . Drives the strategic ... of all operations by working closely with external vendors, manager (s), clinical pharmacist(s), and other support staff....Oversees improvement in Part D Safety Measures Star scores, HEDIS and others as assigned giving great attention to… more
- CenterWell (Kissimmee, FL)
- …first** As a Medical Assistant/Phlebotomist, you will be a part of the Clinical Care Team engaging with our patients to develop lifelong well-being and health. ... are multiskilled health professionals responsible for performing administrative and clinical tasks in our primary care facilities while delivering outstanding… more
- Penn Medicine (Bala Cynwyd, PA)
- …practices and leadership as appropriate + Responsible for the creation, review , revision and communication of clinical /safety related policies **Credentials:** ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- AmeriHealth Caritas (Manchester, NH)
- …SUD and BH services to all Members by associates and Providers. + Serves as clinical advisor and manager for all clinically related SUD and BH activities. + ... Disorder and Behavioral Health (Med. Dir. SUD/BH) provides organizational leadership and clinical oversight and direction for the substance use disorder (SUD) and… more
- AmeriHealth Caritas (Newark, DE)
- …organizational leadership in the operational areas of care management, utilization review , appeals, quality improvement and related policy and practice initiatives ... practice guidelines throughout the provider network. + Overseeing the quality of clinical care for network and non-network providers. + Engaging the provider network… more
- CenterWell (Stone Mountain, GA)
- …Medical Director is also responsible for administrative oversight and outcomes for clinical providers designated to their area. Keeps a medical history and medical ... time dedicated to administrative duties related to oversight of clinical provision of care in their area. + Requires...perspective of the market. + Assist in Ongoing Chart Review monitoring. + Assist with recruitment and interviewing as… more
- CenterWell (Lebanon, TN)
- …histories in electronic medical records software + Phone Triage using critical clinical judgement. + Delivering results to patients as providers direct. + Performing ... screened for TB. + Excellent customer service + Strong clinical background + The ability to adapt and work...+ Experience with Electronic Medical Records + Experience with HEDIS + Knowledge of primary care medicine requirements (state… more
- ERP International (Fallon, NV)
- …recommend corrective action when problems exist. Collaborate with the Population Health Program Manager , review and make recommendations as necessary to improve ... ambulatory setting. Assist in the planning, organizing, and support of clinical operations to include providing technical support and guidance to paraprofessional… more