- Elevance Health (Mason, OH)
- **Business Information Consultant Sr ( HEDIS )** **Location:** This position will work a hybrid model (remote & office). The ideal candidate will live within 50 ... one of our Elevance Health PulsePoint office locations. The **Business Information Consultant Sr ( HEDIS )** is responsible for coordinating and consolidating… more
- Elevance Health (Columbus, OH)
- **Process Improvement Director- HEDIS ** **Location:** This position will work a hybrid model (remote and office). Must reside within 50 miles/1hour commute from the ... posted Elevance Health locations. This **Process Improvement Director- HEDIS ** will be responsible for enterprise HEDIS improvement and governance programs, with… more
- CVS Health (Phoenix, AZ)
- …The QM Nurse Consultant is a work at home role. Experienced HEDIS record review nurse will be responsible for obtaining, reviewing, abstracting, and data ... **Position Summary** This is a fulltime Quality Management Nurse Consultant opportunity within Arizona. The working schedule is Monday-...entering medical records utilized for HEDIS (R) supplemental data processes. Candidate must understand the… more
- Highmark Health (Harrisburg, PA)
- …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
- Elevance Health (Columbus, OH)
- **Advanced Analytics Consultant ** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per week). Ideal candidates will live or be ... FL, Wallingford, CT, Iselin, NJ, or Houston, TX. The **Advanced Analytics Consultant ** employs advanced analytics to gain critical insights into member behavior… more
- Elevance Health (Denver, CO)
- …working in the local office 1-2 days per week. The **Care Consultant Sr.** for **Provider Success** is responsible for consulting with providers (Commercial, ... to identify key opportunity areas and provider needs. + Consultant support model consists of a continuous process of...and tracking to defined outcomes preferred. + Experience with HEDIS and quality preferred. For candidates working in person… more
- Elevance Health (Walnut Creek, CA)
- **Wellness Nurse Consultant ** **Sign Bonus: $5000** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance Health, Inc. family of ... the territory/market that they will work in._ The **Wellness Nurse Consultant ** position is responsible for developing and recommending customized, group-specific… more
- Humana (Tallahassee, FL)
- …health first** The Humana Florida Team is seeking a Senior STARS Improvement Consultant / Professional who will work directly with the Stars Improvement Lead to ... critical features of large scale projects. Florida The Senior STARS Improvement Consultant / Professional + Critical thinker who has initiative to manage multiple… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Risk Adjustment Performance Improvement Consultant , you will be responsible for: + Serving as a Subject Matter Expert (SME) for ... offered by the health plan + Act as a consultant and partner to the contracted IPAs + Traveling...Knowledge of HIPAA regulations * Knowledge of Medicare Advantage, STARS/ HEDIS program, and NCQA technical specifications, a plus *… more
- Guidehouse (Atlanta, GA)
- …Trust **What You Will Do:** As an AI/ML Health Data Science Senior Consultant with Guidehouse you will present during meetings, summits, and working sessions with ... + Experience with commercial health datasets, eg, claims, encounters, risk scoring, HEDIS measures, etc. + Knowledge of recent and ongoing public health initiatives… more
- Stanford Health Care (Palo Alto, CA)
- …external visibility and attention (eg CMS, HealthGrades, US News & World Report, HEDIS , PQRS). **Licenses and Certifications** + None **These principles apply to ALL ... employees:** **SHC Commitment to Providing an Exceptional Patient & Family Experience** _Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing… more
- Community Based Care of Brevard, Inc. (Orlando, FL)
- …to ensure that the enrollee attends a seven (7) day follow up appointment. HEDIS Care Gap Reports - Essential Function: Review of health and wellness reports (ie, ... HEDIS Care Gap Reports), provided by Sunshine Health, which...the CBCIH Regional Coordinator and CBCIH Behavioral Health Care Consultant as needed, or upon request. Documentation - Essential… more
- ChenMed (Columbus, OH)
- …needed. **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Acts as a national pharmacy consultant for our physicians regarding patient case inquiries, drug interactions, ... activities related to specialty practice, as well as Part D education for HEDIS measures. + Acts as the pharmacy department's representative on pertinent committees… more
- ChenMed (Miami, FL)
- …and management of the formulary. + Acts as a national pharmacy consultant for our physicians regarding patient case inquiries, drug interactions, therapy ... activities related to specialty practice, as well as Part D education for HEDIS measures. . + Represents the pharmacy department on applicable committees and teams,… more
- ERP International (Eglin AFB, FL)
- …to provide for total needs of the patient. * Act as a consultant and clinical resource for personnel through the use of evidence-based knowledge and ... Record (PIMR) and Healthcare Effectiveness Data and Information Set ( HEDIS )measures. **Qualifications** **Minimum Qualifications:** Education:** BSN Degree **or** Associates… more
- VNS Health (Manhattan, NY)
- …analysis and interpretation designed to improve clinical outcomes. . Serves as consultant for unusual and difficult medical cases. Participates in the QARR/ HEDIS ... Quality Improvement Activities and utilization management of the population. Works under limited direction. Compensation Range:$243,000.00 - $324,000.00 Annual What We Provide + Referral bonus opportunities + Generous paid time off (PTO), starting at 30 days… more
- CenterWell (Dallas, TX)
- …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
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