- AmeriHealth Caritas (Newtown Square, PA)
- Role Overview:; The Senior Data Analyst - HEDIS Reporting is responsible for managing, analyzing, and interpreting healthcare data to support HEDIS reporting and ... quality improvement initiatives.; This role reports to the Manager, HEDIS Analytics. The Senior Data Analyst HEDIS ...Manager, HEDIS Analytics. The Senior Data Analyst HEDIS Reporting will collaborate with cross-functional teams, such as… more
- Molina Healthcare (Scottsdale, AZ)
- …Quality Reporting team. Designs and develops reporting solutions to assist HEDIS Outbound, Inbound extracts, Data Ingestions, Dashboards, Reports & Extracts for ... Preferred Experience 5+ Years of experience in working with HEDIS tools such as Inovalon or ClaimSphere 5+ Years...or ClaimSphere 5+ Years of experience in working with HEDIS Domain - such as Measure analysis/reconciliation on data… more
- ChenMed (Southfield, MI)
- …to exam rooms and ensures their comfort and well-bring prior to leaving. Acts as HEDIS champion for the PCP by providing visibility of HEDIS needs for scheduled ... patients. Reports on hospitalizations including HITS census, ENS Ping, etc. Presents patients with customer service survey during check out and escalates if needed for immediate service recovery. Participates in daily and weekly huddles to provide details on… more
- Optum (Dallas, TX)
- …patients Working knowledge of Medicare Advantage Risk plans Understanding of HEDIS measurements and delivering value-based care Compensation for this specialty ... generally ranges from $229,50 to $378,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and… more
- Molina Healthcare (Grand Rapids, MI)
- …Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) Advanced understanding on ... health care financial terms (eg, PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form). Advanced understanding of key managed care concepts and provider reimbursement principles… more
- Evolent (Oklahoma City, OK)
- …Experience with value-based care, utilization management, or regulatory reporting (eg, HEDIS , NCQA, Milliman) is preferred. To ensure a secure hiring process ... we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive… more
- UnitedHealth Group (Philadelphia, PA)
- …therapy gaps for key chronic disease states, formulary compliance targets, and HEDIS and NCQA measures Facilitates ongoing maintenance of client custom formulary and ... utilization management updates Identifies opportunities to increase efficiency Mentors clinical coordinators, as needed You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it… more
- UnitedHealth Group (Portland, OR)
- …patient stability is consistent with their goals of care. Participates in HEDIS measure campaigns and other quality initiatives to ensure the highest standards ... of care and to promote the improvement of care management and delivery Home Base Medical Care, a part of Optum, was created to transform how healthcare is delivered to the most medically vulnerable members in our community. Our medical group provides… more
- Molina Healthcare (Mesa, AZ)
- …Knowledge of value based programs, risk adjustment models, quality metrics such as HEDIS and STARS, knowledge of coding Knowledge of medical economics and financial ... reporting. Must be able to walk stakeholders (internal and external) through basic financial reconciliations. Excellent leadership skills, especially ability to influence others who are not in a direct reporting line including ability to think strategically,… more
- Commonwealth Care Alliance (Boston, MA)
- …or related area Demonstrated experience interpreting and applying quality measures ( HEDIS , CAHPS, HOS) and value-based contract performance metrics Experience with ... Medicare Advantage, Medicaid; and dually eligible populations Desired Experience Experience managing or supporting pay-for-performance or value-based care programs. Experience leading provider education or training sessions. Exposure to health equity… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …In-depth understanding of complex claims procedures and medical terminology Knowledge of HEDIS , DOC, HCFA, and NCQA requirements Ability to act as a resource ... and trainer for claims processors Diversity Statement At BroadPath, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and… more
- CenterWell Senior Primary Care (Fort Worth, TX)
- …environment. Knowledge of Medicare guidelines and coverage. Knowledge of HEDIS quality indicators. Additional Information: Guaranteed base salary + bi-annual ... bonus Excellent benefit package ? health insurance effective on your first day of employment CME Allowance/Time Occurrence Based Malpractice Insurance Relocation and sign-on bonus options 401(k) with Employer Match Life Insurance/Disability Paid Time… more
- CenterWell Senior Primary Care (Corpus Christi, TX)
- …environment. Knowledge of Medicare guidelines and coverage. Knowledge of HEDIS quality indicators. Spanish language ability Additional Information: Guaranteed base ... salary + bi-annual quality incentive Excellent benefit package ? health insurance effective on your first day of employment CME Allowance/Time Occurrence Based Malpractice Insurance Relocation and sign-on bonus options 401(k) with Employer Match Life… more
- CenterWell Senior Primary Care (Brownsville, TX)
- …environment. Knowledge of Medicare guidelines and coverage. Knowledge of HEDIS quality indicators. Additional Information: Guaranteed base salary + bi-annual ... bonus Excellent benefit package ? health insurance effective on your first day of employment CME Allowance/Time Occurrence Based Malpractice Insurance Relocation and sign-on bonus options 401(k) with Employer Match Life Insurance/Disability Paid Time… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Sr. HEDIS Coordinator position in the Quality Improvement department. This is a full time position working Monday ... Pittsburgh or surrounding area to be considered! The Sr. HEDIS Coordinator will assists with the management of ...HEDIS Coordinator will assists with the management of HEDIS Coordinator activities in addition to performing the day-to-day… more
- Centene Corporation (Springfield, IL)
- …that meets directly with provider groups based in the Chicago area to discuss HEDIS performance and strategize ways to improve performance, up to 75% travel. Typical ... provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures,… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a HEDIS Coordinator position in the Quality Improvement department. This is a full time position working Monday ... Application from network physicians and Health Plan staff, to support for HEDIS measure compliance or potential measure exclusion. Responsibilities: + Adhere to the… more
- Providence (CA)
- …empower them._** **Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:** + Be responsible for conducting clinical quality audits/overreads ... to determine potential areas for quality improvement within the HEDIS project + Collect data by way of chart...specifications for the Healthcare Effectiveness and Data Information Set ( HEDIS ) program + Conduct Audits inclusive of review of… more
- Molina Healthcare (TX)
- …Quality Reporting team. Designs and develops reporting solutions to assist HEDIS Outbound, Inbound extracts, Data Ingestions, Dashboards, Reports & Extracts for ... Experience** * 5+ Years of experience in working with ** HEDIS ** tools such as **Inovalon** or **ClaimSphere** * 5+...**ClaimSphere** * 5+ Years of experience in working with HEDIS Domain - such as Measure analysis/reconciliation on data… more
- US Tech Solutions (May, OK)
- …outreach, collection, and review of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to the start of the ... in any way possible to complete the screenings. * Search for relevant HEDIS records from databases, review medical records using HEDIS technical specification… more
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