• HEDIS Clinical Quality

    Elevance Health (Indianapolis, IN)
    JR132653 HEDIS Clinical Quality Program Manager **Location:** This position requires you to reside within 50 miles (and 1 hour commute) of any open, ... your local office location a minimum of 1 day/week. The ** HEDIS ** ** Clinical Quality Program Manager ** is responsible for serving as a liaison with and… more
    Elevance Health (10/25/24)
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  • Lead Abstractor, HEDIS / Quality

    Molina Healthcare (Paducah, KY)
    …National Over read team, National Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. + Mentor ... **C** **E/KNOWLEDGE, SKILLS & ABILITIES:** + 5 years experience in healthcare Quality / HEDIS specific to medical record review and abstraction + Intermediate… more
    Molina Healthcare (10/25/24)
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  • Sr Analyst, HEDIS / Quality

    Molina Healthcare (MI)
    …federal/state QI 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...to completion + Works with Director and / or Manager to establish and / or document quality more
    Molina Healthcare (10/20/24)
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  • Clinical Quality Program…

    Elevance Health (Topeka, KS)
    …**Required Qualifications:** + Requires a BS in health administration, nursing, or a related clinical field; 4 years of health care quality or data analysis ... to support an operational team responsible for abstraction and pursuit of HEDIS (R) measures to ensure they reach operational milestones, gap closures, rates and… more
    Elevance Health (10/12/24)
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  • Clinical Quality Program…

    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 ... net required to achieve that purpose. Job Summary The Clinical Quality Program Manager is...(HOS) and /or Healthcare Effectiveness Data and Information Set ( HEDIS ), Medication Adherence and Plan Operations and /or other… more
    LA Care Health Plan (11/07/24)
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  • Manager , Clinical Quality

    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 ... net required to achieve that purpose. Job Summary The Manager of Clinical Quality Analytics...strategies to enable accountable entities and stakeholders to drive quality ratings improvement for CAHPS, HOS, HEDIS ,… more
    LA Care Health Plan (08/28/24)
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  • Clinical Quality Program…

    Elevance Health (Miami, FL)
    **JR131500 Clinical Quality Program Manager **...will you make an impact:** + Leads plan level HEDIS strategy to drive improvement in behavioral health ... reporting is in place. + Develops performance improvement plans and oversees the clinical quality improvement activities/projects to improve the quality of… more
    Elevance Health (10/23/24)
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  • Quality Improvement (RN) - Maternity…

    Molina Healthcare (Ypsilanti, MI)
    …RN license for the State(s) of employment **Preferred Education** Preferred field: Clinical Quality , Public Health or Healthcare. Nursing: Master's or higher ... or more of these quality improvements functions: Quality Interventions, Quality Improvement Compliance, HEDIS...quality activities. + Monitors and ensures that key quality activities that involve clinical decision-making are… more
    Molina Healthcare (10/20/24)
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  • Clinical Quality Program…

    Elevance Health (Tampa, FL)
    **Be Part of an Extraordinary Team** **Title** : Clinical Quality Program Manager **Location:** Candidates must reside within 50 miles or 1-hour commute each ... days/week, WFH 4-5 days/week. **Build the Possibilities. Make an Extraordinary Impact.** The ** Clinical Quality Program Manager ** is responsible for serving… more
    Elevance Health (10/16/24)
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  • Center Clinical Manager

    ChenMed (Philadelphia, PA)
    …with the development and execution of business strategies that increase revenue and quality ratings ( HEDIS /STARS/ Clinical Gaps) and support our core model. ... need great people to join our team. The Center Clinical Manager (CCM) at our North Philadelphia...operations, which may include but is not limited to: clinical quality , compliance, human resources, patient experience… more
    ChenMed (09/06/24)
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  • Clinical Nurse, Federal Employee Program…

    Blue KC (Workman, MN)
    …health needs through communication and available resources to promote member safety, quality of care and cost-effective outcomes. + Completes complex and disease ... culturally sensitive way. Uses standardized tools to complete assessments addressing clinical support and social determinants of health needs. + Conducts… more
    Blue KC (11/05/24)
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  • Clinical Quality Program Consultant

    Elevance Health (Tampa, FL)
    **Be Part of an Extraordinary Team** **Title** : Clinical Quality Program Consultant **Location:** Candidates must reside within 50 miles or 1-hour commute each ... WFH 3-4 days/week **Build the Possibilities. Make an Extraordinary Impact.** The ** Clinical Quality Program Consultant** is responsible for serving as a… more
    Elevance Health (10/11/24)
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  • Clinical Quality Program…

    Elevance Health (Tampa, FL)
    **Be Part of an Extraordinary Team** **Title** : Clinical Quality Program Admin **Location:** Candidates must reside within 50 miles or 1-hour commute each way ... WFH 3-4 days/week **Build the Possibilities. Make an Extraordinary Impact.** The ** Clinical Quality Program Administrator** is responsible for overseeing the … more
    Elevance Health (10/11/24)
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  • Clinical Quality Program Specialist

    Elevance Health (KS)
    …must reside within 50 miles of our Olathe or Topeka PulsePoint. The ** Clinical Quality Program Specialist** is responsible for supporting projects and assisting ... compliance of corporate Quality Improvement (QI) work plans. + Supports Clinical Quality Program with maintaining effective documentation to meet regulatory… more
    Elevance Health (10/11/24)
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  • Clinical Pharmacist - Huntsville, AL

    The Cigna Group (Bloomfield, CT)
    Clinical Pharmacist - Cigna Medicare The Embedded Clinical Pharmacist is responsible for the daily activities of the pharmacy programs. Assists with the ... development and execution of numerous initiatives that improve the quality or cost effectiveness of drug therapy in coordination with other care team members and… more
    The Cigna Group (10/01/24)
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  • Senior Medical Management Nurse - VCHCP

    Ventura County (Ventura, CA)
    …two (2) years of full-time experience in Case Management, Disease Management, Quality Assurance, HEDIS and/or Utilization Review. NECESSARY SPECIAL REQUIREMENTS ... 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
    Ventura County (10/24/24)
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  • Behavioral Health Clinical Quality

    Elevance Health (Seven Fields, PA)
    …+ Performs monthly, quarterly, annual and ad hoc medical record reviews such as HEDIS and CPG compliance. + Conducts quality of care investigations and using ... Fields, PA; Hermitage, PA Responsible for participating in on-site quality external audits such as NCQA, AAHC and EQRO,...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (10/04/24)
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  • Senior Manager , Practice Innovation

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

    Penn Medicine (Bala Cynwyd, PA)
    …events. This position is accountable for facilitating improvement in the areas of clinical quality and patient safety, patient satisfaction and clinical ... include Princeton, Cape May & Somers Point)** Summary: The Quality and Patient Safety Manager participates in...operations. Responsibilities: + Facilitate improvement in patient experience, clinical quality and operations + Serves as… more
    Penn Medicine (09/27/24)
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  • Manager Provider Government Programs

    Highmark Health (Buffalo, NY)
    …the ROI and fiscal targets as set by Highmark, cost and utilization and quality results in Medicare STARS, Medicaid HEDIS and risk revenue government programs. ... This job is responsible for the performance and development of the clinical consultants into highly functioning subject matter experts in the Organization's Primary… more
    Highmark Health (11/04/24)
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