- Highmark Health (Buffalo, NY)
- …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 ... PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value creation, cost control… more
- Two95 International Inc. (New York, NY)
- Job Title: Sr. Analytics Consultant Job type : Remote Work Type : 6+ Months Contract with extension Rate : $Market /Hour Requirements Job Description: Primary ... Python and R, or similar * Deep familiarity with HEDIS & CMS care quality measures; experience implementing both... & CMS care quality measures; experience implementing both HEDIS and CMS measures using SAS and/or SQL *… more
- Humana (Gainesville, FL)
- …of programs. + Provider non-standard supplemental data trending + Provider level HEDIS in service + Develop and implement measure specific strategies + Provider ... establish working relationships + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial performance… more
- Elevance Health (Cincinnati, OH)
- **Wellness Nurse Consultant ** **Sign on Bonus: $5000** **Field:** This field-based role enables associates to primarily operate in the field, traveling to client ... will drive the future of health care. The **Wellness Nurse Consultant ** position is responsible for developing and recommending customized, group-specific strategies… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | Eagan, Minnesota Career Area: Customer Service/Operations About ... subject matter experts on coding accuracy and Quality programs such as including HEDIS and Stars. Your Responsibilities As part of a Blue Cross provider-performance… more
- Elevance Health (Tampa, FL)
- …initiatives strongly preferred + Government Business Experience strongly preferred + HEDIS /STARS experience preferred + Ability to Develop/code in SQL preferred + ... SAS/Python Experience preferred + Data Analysis experience is a must + Value Based care experience nice to have Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any… more
- LA Care Health Plan (Los Angeles, CA)
- …needs; this plan includes Application Roadmaps, Staffing Model (FTE and Consultant ), SOA Service Definition, Data Management/Interfaces. This position works closely ... At least 4 years of IT Vendor (Software and Consultant ) Management. Preferred: At least 3 years of Production...years of Clinical Care and 3 years of HIE, HEDIS experience preferred. Functional knowledge of HEDIS ,… more
- University of Southern California (Alhambra, CA)
- …individual's health care needs to promote cost-effective, quality outcomes. Serves as a consultant to members of the health care team in the management of specific ... forms timely. 12. Completes disposition form for medicare patients timely. + Consultant 1. Demonstrates sound clinical knowledge base regarding CM standards, UM… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and divisional meetings, including in person meetings. + Serves as a resource and consultant to other areas of the company. + May be required to represent the ... the utilization management program policies and procedures. + Serves as a resource and consultant to other areas of the company. + Assists in many aspects of… more
- Actalent (Chandler, AZ)
- …+ Collaborate with the primary care team and clinical performance consultant to effectively manage value-based lives. + Disclose relevant training, experience, ... Experience with quality measures such as care gap closures, pre-visit planning, HEDIS measures, and patient outreach. + Strong ability to follow instructions,… more
- ChenMed (Orlando, FL)
- …hospital sick days), CG CAHPS and net promoter score (patient experience), HEDIS and clinical gaps closures, and medical cost effectiveness measures. Each primary ... **Coaching for health** : Act as a health coach, rather than just a consultant for sickness, by helping patients set short and long-term health goals, partners with… more
- Trinity Health (Boise, ID)
- …and/or performance/process improvement role preferred. + Knowledge of NCQA and HEDIS standards and Medicare Advantage Star ratings gained through experience strongly ... **ESSENTIAL FUNCTIONS:** + The Performance Improvement Specialist will function as a consultant in the field, supporting, educating providers within the SAHA network… more
- ChenMed (Richmond, VA)
- …for health: The Lead PCP acts as a health coach, rather than just a consultant for sickness, by helping patients set short and long-term health goals, partners with ... 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 effectiveness… more
- Insight Global (Newtown, PA)
- …organization. You will leverage your understanding of healthcare data standards (ie HEDIS , FHIR, CMS interoperability, etc.) and Azure Data Platform (Databricks, ADF ... for data specific projects - 5+ years of experience as a Lead/ Consultant /Manager strategically building out QA/Test capabilities - 5+ years in the healthcare… more
- CenterWell (Phoenix, AZ)
- …environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation ... others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.… more
- ERP International (Barksdale AFB, LA)
- …T-CON, as applicable. In most cases a referral to the Internal Behavioral Health Consultant (IBHC) in Primary Care is appropriate for an initial referral for mental ... of disease management programs and clinical practice guidelines (eg VA/DoD CPGs), and HEDIS Measurements. + Teaches patients and family member's ways to maintain or… more
- CenterWell (Seneca, SC)
- …environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation ... others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.… more
- Veterans Affairs, Veterans Health Administration (Kenosha, WI)
- …quality outcomes, care coordination, screenings), Healthcare Effectiveness Data and Information Set ( HEDIS ), All Employee Survey scores, and other metrics as to be ... and continuous responsibility for directing and managing an integrated program. - Consultant to medical center staff and greater community in areas of expertise.… more
- Covenant Health Inc. (Knoxville, TN)
- …coordinating education of staff and patients and serving as a clinical resource and consultant to the health care team. The RN Care Coordinator II is responsible for ... care. + Stays abreast of most recent changes in quality related to HEDIS measures, CMS Conditions of Participation, MIPS and other regulatory requirements to assist… more
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