- A-Line Staffing Solutions (St. Louis, MO)
- …Skills/ Experience: Accounting Knowledge/Degree Microsoft Teams Knowledge Economics and/or business analyst entry level Why Apply: Full benefits available after 90 ... analysis, Medical Coding, Denials, Grievance, Grievance and Appeals, Appeals and Denials, HEDIS , STARS, CMS, Medicare, Medicaid, PBM, Claims, Rx, Health Plan, Health… more
- Medical Mutual of Ohio (OH)
- …well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** ** HEDIS Analyst I** Supports corporate and departmental strategies ... Participates in required trainings and performs other duties as assigned. ** HEDIS Analyst II** Supports corporate and departmental strategies and goals in… more
- CareOregon (Portland, OR)
- …Montana, or Wisconsin. Position Title: Cotiviti Applications System Administrator / HEDIS Analyst Exemption Status: Exempt Department: Information Systems ... flow Preferred: + 3+ years of Cotiviti experience + HEDIS exp to include Stars and/or HEDIS ...+ HEDIS exp to include Stars and/or HEDIS measures + Bachelor's degree in Computer Science, Information… more
- Trinity Health (Columbus, OH)
- …Columbus. Learn more at www.experiencecolumbus.com ! **About the job:** The Analyst is responsible for assisting the department with data collection, verification, ... of systems. + Manages the annual Healthcare Effectiveness Data and Information Set ( HEDIS ) audit and submission. **What we're looking for** : + Education: Bachelor's… more
- The Cigna Group (Nashville, TN)
- …local strategic objectives with tactical demands. We are seeking an experienced HEDIS (R) analyst who thrives on supporting sophisticated business challenges ... technical skills to study and analyze systems needs and provide HEDIS (R)thought leadership and technical expertise across multiple disciplines, supporting our… more
- CVS Health (Topeka, KS)
- …VA + San Antonio, TX + Southern, IL Position Summary This Senior Analyst , Healthcare Quality Management will be a Quality Practice Liaison who builds positive ... for providing education related to National Committee for Quality Assurance (NCQA) HEDIS measures, medical record documentation, and coding. They will function as a… more
- CVS Health (Topeka, KS)
- …+ Dallas, TX + Lexington, KY + Southern Region, IL Position SummaryThis Analyst Healthcare Quality Management will be a Quality Practice Liaison who builds positive ... for providing education related to National Committee for Quality Assurance (NCQA) HEDIS measures, medical record documentation, and coding. They will function as a… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …contracting regions with quality, utilization, and cost analysis. **Provider Network Performance Analyst I** + Gathers and maintains data from multiple sources and ... contracting initiatives. + Performs other duties as assigned. **Provider Network Performance Analyst II** + Conducts quality assurance analysis on data from multiple… more
- Highmark Health (Dover, DE)
- …identify gaps and communicate results. Conduct continuing education to providers on STARS, HEDIS , and HCC Coding. Conduct re-audits as needed. + Other duties as ... of combined experience with RN/LPN, Risk Adjustment HCC Coding, medical coding/billing, HEDIS , and/or health related field in lieu of bachelor's degree **Preferred**… more
- AdventHealth (Tampa, FL)
- **GENERAL SUMMARY:** **The Training Analyst I is responsible for implementing standardized clinical, revenue cycle, and practice operations training strategies for ... AdventHealth Medical Group. The Analyst will collaborate with the Physician Enterprise Training Delivery...of quality reporting and physician practice regulatory programs (eg, HEDIS , MIPS) . Experience in process mapping and process… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Medicaid Quality Analyst is responsible for defining, measuring, analyzing, and evaluating population health, while ... prioritizing, developing, and operationalizing innovative initiatives to improve HEDIS measure performance, the quality of care and experience, resulting in… more
- LA Care Health Plan (Los Angeles, CA)
- Clinical Data Analyst III Job Category: Clinical Department: Quality Improvement Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11152 ... net required to achieve that purpose. Job Summary The Clinical Data Analyst III supports Healthcare metrics, quality and process improvement activities by producing… more
- University of Miami (Miami, FL)
- …Health System, "UHealth", IT Department has an exciting opportunity for an Epic Analyst - Healthy Planet. The Epic Analyst provides oversight and leadership ... to optimize the application's configuration, function, and access. The Epic Analyst facilitates day-to-day application support and resolving application issues and… more
- Highmark Health (Columbus, OH)
- …requirements. The incumbent provides analysis in the develop and support of HEDIS and Medicare Star data analysis. Determines how decision support systems will ... experience, particularly with Informatica PowerCenter. + Experience within Quality Analytics, HEDIS or Medicare Star + Proficiency in any of the following… more
- Centene Corporation (NV)
- …ongoing quantitative and statistical analysis of performance data to include HEDIS measures, service utilization and member/provider complaint trends + Develop ... HEDIS measures, service utilization and all quality report extraction specifications + Develop and update quarterly, annual and ad hoc reports including analysis and… more
- The Cigna Group (Hattiesburg, MS)
- …manage relationships with participating provider practices. Maintain detailed understanding of HEDIS / STAR performance measures. Develop and maintain a process to ... utilization management position (experience can be a combination of LVN/RN licensure) + Previous HEDIS and/or CMS STARs experience a plus If you will be working at… more
- Cleveland Clinic (Cleveland, OH)
- …of the most respected healthcare organizations in the world. Systems Analyst IIIs participate in feasibility analysis, estimating, planning, designing, developing, ... through use of technology. + The Value Based Performance Analyst serves as a key member of Value Based...organization and healthcare consulting. + Knowledge of Value Based Contracts/ HEDIS /CMS preferred + Strong SQL Skills + Healthcare terminology… more
- Fallon Health (Worcester, MA)
- …general direction of the Senior Manager, Clinical Quality, the clinical nurse analyst is responsible for developing and implementing the assigned quality improvement ... medical record data abstraction for Healthcare Effectiveness Data and Information Set ( HEDIS (R)) and MassHealth Appendix Q review. The clinical nurse analyst … more
- CareFirst (Baltimore, MD)
- …work experience. **Experience:** 5 years as a risk adjustment HCC analyst or experience collaborating with Finance and Actuary Teams. **Preferred Qualifications:** ... Quality or Process Improvement Methods + Direct experience with accreditation, HEDIS , CAHPS and other quality related activities a healthcare relatedenvironment… more
- Centene Corporation (Tallahassee, FL)
- …of the following areas: claims, provider data, member data, clinical data, HEDIS , pharmacy, external reporting + Extract, load, model, and reconcile large amounts ... of data across multiple system platforms and sources + Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management + Develop reports and deliverables for management + Model data… more
