- Premera Blue Cross (Mountlake Terrace, WA)
- …and Provider Network Executives, the **Quality and Risk Adjustment - Provider Clinical Consultant (PCC)** works directly with providers to evaluate, recommend, ... and monitor the implementation of better practice processes for improved outcomes that focus on keeping...that focus on keeping Premera members healthy. The Provider Clinical Consultant will work directly and build… more
- Highmark Health (Harrisburg, PA)
- …in Medicare STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to ... is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office based support to… more
- CVS Health (Tallahassee, FL)
- …The QM BH Consultant reviews documentation and interprets data obtained from clinical records or systems to document root cause of high utilization of care. The ... QM BH Consultant develops and implements data-driven strategies/interventions that ensure the...to document as-is and to-be processes. + Assess current practice patterns, assets and challenges utilizing HEDIS ,… more
- Defense Health Agency (Lackland AFB, TX)
- …the director of medical services (SGH) to promote the use of evidence-based clinical practice guidelines and pathways. Advocates case management for smooth ... **Overview** Nurse Consultant Joint Base San Antonio Time to invest...of care. Assists in research and development of evidence-based clinical practice guidelines (CPG) in collaboration with… more
- Stanford Health Care (Palo Alto, CA)
- …medium scale, service or unit specific, performance improvement initiatives. Combines the clinical acumen required to change practice with the leadership skills ... improvement work, including but not limited to resource utilization, physician practice patterns, and clinical pathway effectiveness. Designs and develops… 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 ... Act as a health coach, rather than just a consultant for sickness, by helping patients set short and...VIP service, standards of care and quality guidelines, and HEDIS /STARS + Inspire seamless coverage of clinical … more
- Community Based Care of Brevard, Inc. (Orlando, FL)
- …Suitability Assessments receive them in accordance with Florida Statute, provide clinical consultation and support and ensure funding authorization for children in ... enrollee attends a seven (7) day follow up appointment. HEDIS Care Gap Reports - Essential Function: Review of...the CBCIH Regional Coordinator and CBCIH Behavioral Health Care Consultant as needed, or upon request. Documentation - Essential… more
- VNS Health (Manhattan, NY)
- … clinical expertise, in depth data analysis and interpretation designed to improve clinical outcomes. . Serves as consultant for unusual and difficult medical ... OverviewProvides clinical expertise and guidance to the daily operations...cases. Participates in the QARR/ HEDIS Quality Improvement Activities and utilization management of the… more
- ChenMed (Richmond, VA)
- …count for 2 slots, follow-up patients, typical 1.0 PCP FTE slots are 18-21), HEDIS >4, CG CAHPS (patient experience), clinical gaps closures, and medical cost ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...of employment is required + A minimum of 1-year clinical experience in geriatric, adult or family practice… more
- CenterWell (Dallas, TX)
- …+ Valid, unrestricted license in the state of desired employment + Experience leading clinical practice operations + Demonstrate a high level of skill with ... Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value based environment + Leveraging Technology: You are… more
- ERP International (Eglin AFB, FL)
- …inter-departmentally, to provide for total needs of the patient. * Act as a consultant and clinical resource for personnel through the use of evidence-based ... professionals. Facilitate the achievement of optimal outcomes in relation to clinical care, quality and cost effectiveness. * Ensure compliance with standards… more
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