• HEDIS Clinical Quality Program…

    Elevance Health (Indianapolis, IN)
    JR132653 HEDIS Clinical Quality Program Manager **Location:** This position requires you to reside within 50 miles (and 1 hour commute) of any open, relevant ... your local office location a minimum of 1 day/week. The ** HEDIS ** **Clinical Quality Program Manager ** is responsible for serving as a liaison with and… more
    Elevance Health (10/25/24)
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  • Sr Medical Records Collector - Remote (PST)

    Molina Healthcare (Long Beach, CA)
    …pursuit and collection of medical records and other data in collaboration with other HEDIS staff. + Assists the Manager and Supervisor(s) and/or performs the ... and reports from provider offices, loads data into the HEDIS application. + Assists the manager /lead and...into the HEDIS application. + Assists the manager /lead and quality improvement staff with physician and member… more
    Molina Healthcare (09/06/24)
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  • Medical Records Collector

    Molina Healthcare (AZ)
    …pursuit and collection of medical records and other data in collaboration with other HEDIS staff. + Assists the Manager and Supervisor(s) and / or performs ... in PST hours 8-5pm M-F.** **JOB DESCRIPTION** **Job Summary** Molina's HEDIS /Quality Improvement Medical Records Collector will work collaboratively in outreaching… more
    Molina Healthcare (11/07/24)
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  • Medical Records Collector-(Remote) Must reside…

    Molina Healthcare (New York, NY)
    …pursuit and collection of medical records and other data in collaboration with other HEDIS staff. * Assists the Manager and Supervisor(s) and / or performs ... **JOB DESCRIPTION** **Job Summary** Molina's HEDIS /Quality Improvement Medical Records Collector will work collaboratively...system retrieval and direct onsite pick up, for the HEDIS projects. **Job Duties** * Under the direction of… more
    Molina Healthcare (11/02/24)
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  • Lead Abstractor, HEDIS /Quality Improvement…

    Molina Healthcare (Paducah, KY)
    …Lead Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The ... + Performs the lead role in the coordination and preparation of the HEDIS medical record review which includes ongoing review of records submitted by providers… more
    Molina Healthcare (10/25/24)
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  • Business Information Developer Consultant…

    Elevance Health (St. Louis, MO)
    **Business Information Developer Consultant - HEDIS Analytics** **Location:** This position will work a hybrid model (remote and in office one to two days per week). ... Wallingford, CT or Louisville, KY. The **Business Information Developer Consultant - HEDIS Analytics** is responsible for developing and executing more complex data… more
    Elevance Health (10/29/24)
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  • Sr Analyst, HEDIS /Quality Reporting…

    Molina Healthcare (MI)
    …compliance activities. **Candidates residing in Michigan with SQL, Quality/ HEDIS and Health plan experience are strongly preferred.** **KNOWLEDGE/SKILLS/ABILITIES** ... In collaboration with Quality Improvement (QI) management, the Senior Analyst, HEDIS /Quality Reporting develops and provides reports and cost-benefit analysis tools… more
    Molina Healthcare (10/20/24)
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  • Business Information Developer Consultant…

    Elevance Health (Roanoke, VA)
    …of an Extraordinary Team** **Title** : Business Information Developer Consultant - HEDIS Analytics **Location:** Candidates must reside within 50 miles or 1-hour ... issues, reviews, and analyzes data for contracts. + Maintains HEDIS timelines used to support the Medicare project plan...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (11/05/24)
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  • Business Change Director-Star/ HEDIS

    Elevance Health (Atlanta, GA)
    **Business Change Director-Star/ HEDIS Use-Case Lead** **Location:** This position will work a hybrid model (remote and office). Ideal candidates must live within 50 ... PulsePoint location. The **Business Change Director-Use Case Lead for Stars & HEDIS ** is responsible for collaborating with business stakeholders and our IT… more
    Elevance Health (11/02/24)
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  • Clinical Quality Program Manager

    Elevance Health (Topeka, KS)
    …to support an operational team responsible for abstraction and pursuit of HEDIS (R) measures to ensure they reach operational milestones, gap closures, rates and ... **How You Will Make an Impact:** + Manages, coordinates and facilitates HEDIS (R) training, including HEDIS (R) software training, admin and hybrid measure… more
    Elevance Health (10/12/24)
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  • Quality Improvement (RN) - Maternity (OB/GYN)

    Molina Healthcare (Ypsilanti, MI)
    …of these quality improvements functions: Quality Interventions, Quality Improvement Compliance, HEDIS , and / or Quality Reporting. Quality Intervention / QI ... expertise is important to the activity. + Surfaces to Manager and Director any gaps in processes that may...would be valuable to uncover process gaps or limitations. HEDIS / Quality Reporting + Performs the lead role… more
    Molina Healthcare (10/20/24)
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  • Senior Medical Management Nurse - VCHCP

    Ventura County (Ventura, CA)
    …Utilization Management and tasks related to Healthcare Effectiveness Data and Information Set ( HEDIS ) as well as writing reports and analyses in line with the ... complex cases, disease managing certain populations, performing utilization reviews, supervising HEDIS documentation, and writing required analyses to meet or align… more
    Ventura County (10/24/24)
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  • Clinical Quality Program Manager III

    LA Care Health Plan (Los Angeles, CA)
    Clinical Quality Program Manager III Job Category: Clinical Department: Quality Improvement Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... required to achieve that purpose. Job Summary The Clinical Quality Program Manager is responsible for identifying, implementing, and guiding projects relating to… more
    LA Care Health Plan (11/07/24)
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  • Manager , Clinical Quality Analytics

    LA Care Health Plan (Los Angeles, CA)
    Manager , Clinical Quality Analytics Job Category: Clinical Department: Quality Improvement Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... support the safety net required to achieve that purpose. Job Summary The Manager of Clinical Quality Analytics (MSA) is responsible for the operations, projects and… more
    LA Care Health Plan (08/28/24)
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  • Senior Manager , Practice Innovation

    University of Virginia (Charlottesville, VA)
    …to develop relevant in-person and online educational trainings on priority HEDIS quality measures, complex diagnosis documentation for improved risk adjustment, and ... quality metric performance. + Maintains thorough knowledge and understanding of the HEDIS quality measures, their nuances and the specifications to adequately speak… more
    University of Virginia (11/07/24)
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  • Manager Provider Government Programs

    Highmark Health (Buffalo, NY)
    …Highmark, cost and utilization and quality results in Medicare STARS, Medicaid HEDIS and risk revenue government programs. This includes accountability for team ... and Highmark's strategic PCP partners in government programs in Medicare, Medicaid HEDIS and risk revenue, and user interfaces endorsed by the Organization. +… more
    Highmark Health (11/04/24)
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  • Clinic Manager - CenterWell

    CenterWell (Grand Prairie, TX)
    …CenterWell is a subsidiary of Humana, seeking a Primary Care Clinic Manager , that develops and leads implementation for staffing plans, policies and procedures ... patient outcomes and company initiatives including but not limited to Quality, HEDIS / STARs, AHCA, financial management and employee and patient retention. Must… more
    CenterWell (11/02/24)
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  • Clinical Quality Program Manager

    Elevance Health (Miami, FL)
    **JR131500 Clinical Quality Program Manager ** Responsible for serving as a liaison with and overseeing the quality improvement activities/projects/programs for one ... will you make an impact:** + Leads plan level HEDIS strategy to drive improvement in behavioral health ...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (10/23/24)
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  • Clinic Manager - Conviva

    Conviva (Rockport, TX)
    …first** Conviva is a subsidiary of Humana, seeking a Primary Care Clinic Manager , that develops and leads implementation for staffing plans, policies and procedures ... patient outcomes and company initiatives including but not limited to Quality, HEDIS / STARs, AHCA, financial management and employee and patient retention. Must… more
    Conviva (11/05/24)
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  • Risk & Quality Performance Manager (Remote)

    Molina Healthcare (Richmond, KY)
    **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success. * Partner with other teams to ensure data quality… more
    Molina Healthcare (10/17/24)
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