- HarmonyCares (Euless, TX)
- …providers (APPs). This position will have a dyad partnership with the Market Manager and market office staff. Essential Duties and Responsibilities Act as on-site ... and identify areas for improvement leading to superior Quality ( HEDIS ) performance Frequently review clinician capacity and productivity performance. Partner… more
- UCLA Health (Los Angeles, CA)
- Description UCLA Health is seeking an experienced Senior Project Manager to lead critical healthcare quality initiatives, including CMS Star Ratings and HEDIS ... + Lead end-to-end execution of CMS Star Ratings and HEDIS initiatives and manage the entire project lifestyle +...and manage project plans, timelines, and deliverables + Oversee HEDIS operations, including data submission, audits, and hybrid chart… more
- UPMC (Pittsburgh, PA)
- …+ Complete a department identified quality improvement project under the supervision of Manager , ie, development of HEDIS measure Tip Sheet(s), assist with ... UPMC Health Plan has an exciting opportunity for a Sr. HEDIS Coordinator position in the Quality Improvement department. This is a full time position working Monday… more
- Molina Healthcare (OH)
- …within the department and/or collaboratively with other departments. Please include any HEDIS /Quality experience on your resume. This experience is important for the ... to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may...(RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
- The Cigna Group (Bloomfield, CT)
- **Job Profile Summary:** The Business Analytics Sr. Manager oversees a team of analytics professionals focused on clinical quality measurement and insights. Works in ... outcomes through data-driven clinical initiatives. The Business Analytics Senior Manager is responsible for managing complex projects, transforming traditional… more
- LA Care Health Plan (Los Angeles, CA)
- Technical Applications Manager II Job Category: Information Technology Department: IT Solutions Delivery Location: Los Angeles, CA, US, 90017 Position Type: Full ... to achieve that purpose. Job Summary The Technical Application Manager II reports to the Senior Manager ...years of Clinical Care and 3 years of HIE, HEDIS experience preferred. Functional knowledge of HEDIS ,… more
- The Cigna Group (Bloomfield, CT)
- …and drive improvements in patient outcomes. This data will feed into HEDIS (healthcare effectiveness data and information set) and NCQA (national committee for ... teams such as Data Engineering, Interoperability, Clinical Initiatives, and HEDIS Operations **Qualifications:** + Master's degree preferred, or Bachelor's degree… more
- Ventura County (Ventura, CA)
- …members to resolve service issues, ensure regulatory compliance (DMHC, NCQA, HEDIS ), and support wellness, prevention, and disease management programs. This position ... preventing diseases, and maintaining well-being; + Assumes responsibilities related to HEDIS , including data collection, reporting, and ensuring compliance with … more
- Blue KC (MO)
- …discount program** **Job Description Summary:** The Integrated Health Advancement Program Manager leads an integrated behavioral health and health outcome strategy ... + Direct health outcome initiatives addressing systemic barriers to care, disparities in HEDIS and STAR measures, and drivers of social and behavioral health. +… more
- Health Care Service Corporation (Philadelphia, PA)
- …responsible managing daily activities and implementation of strategies for provider HEDIS and STARS performance, recruitment and contracting of physicians, physician ... of providers, and for ongoing provider service. As a manager , this individual will lead a team of Network...stays **Preferred Job Qualifications & Additional Details:** + Previous HEDIS and/or CMS STARs experience + Solid understanding of… more
- Centene Corporation (Sacramento, CA)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... experience at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $26.50 - $47.59 per hour Centene… more
- Centene Corporation (Tallahassee, FL)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc.** **Completes special projects as assigned** ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
- Centene Corporation (Springfield, IL)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
- Centene Corporation (Atlanta, GA)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost (MLR) and utilization. Account management experience strongly preferred.… more
- Avera (Sioux Falls, SD)
- …the Director of Quality and Risk Services, Manager of Risk Adjustment, Manager of Quality, Quality Coordinator - HEDIS , coder(s), claims staff, and primary ... around Risk Adjustment (RA) initiatives and Healthcare Effectiveness Data Information Sets ( HEDIS ). The Quality and Risk Adjustment Specialist will work closely with… more
- University of Southern California (Alhambra, CA)
- In collaboration with the interdisciplinary team, the Case Manager provides care coordination services evaluating options and services required to meet an ... As more complex medical treatment options emerge the Case Manager will look to eliminate gaps in the care...+ Outcomes Management 1. Participates in core measure or HEDIS measure processes in identification of appropriate patients. 2.… more
- Sea Mar Community Health Centers (Puyallup, WA)
- …position(s): Sea Mar is a mandatory COVID-19 and flu vaccine organization Nurse Manager - Posting #26096 Nurse Manager RN Annual Salary: $85,470.00 Nurse ... LPN Annual Salary: $74,958.09 Position Summary: Full-time Nurse Manager position available for our Medical Clinic in Puyallup,...or hospitals + Focus clinic efforts on quality measures, HEDIS , and Meaningful Use standards + Provide annual MA… more
- Commonwealth Care Alliance (Boston, MA)
- …Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating strong, collaborative relationships with behavioral ... coordinated care for members. In this role, the Program Manager acts as an account manager , relationship...priorities. * Track provider progress on performance metrics (eg, HEDIS , readmissions, community tenure) and follow up to support… more
- Fallon Health (New Bedford, MA)
- …us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary team focused on care ... NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager , Aging Service Access Point Geriatric Support Service Coordinator, contracted… more
- Sea Mar Community Health Centers (Vancouver, WA)
- …following position(s): Sea Mar is a mandatory COVID-19 and flu vaccine organization Nurse Manager (RN or LPN) - Posting #26861 Hourly Rate: $36.04 - $44.44 Annual ... $74,958.09 - 92,444.35 (depending on experience) Position Summary: Full-time Nurse Manager position available for our Vancouver - Salmon Creek Medical Clinic.… more
