- Molina Healthcare (MI)
- …Improvement functions (eg, reporting for key performance measurement activities, including HEDIS , state-based measure reporting and medical record review ). + ... QI compliance activities. **Candidates residing in Michigan with SQL, Quality/ HEDIS and Health plan experience are strongly preferred.** **KNOWLEDGE/SKILLS/ABILITIES**… more
- Actalent (Austin, TX)
- Actalent is currently hiring for Remote HEDIS Nurses (RN/LPN)! Job Description: + Lead data collection and abstraction for company quality measures, including ... standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS and other measure sets in compliance with standards +… more
- Actalent (Austin, TX)
- …CMS, and CHIPRA * Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom * Review medical records and abstract data ... Job Description * Lead data collection and abstraction for company quality...vendors Additional Skills & Qualifications * Recent experience with HEDIS , NCQA, Quality Initiatives/Standards. * Previous HEDIS … more
- Insight Global (Philadelphia, PA)
- …) Strong computer skills Ability to occasionally travel to local providers Previous HEDIS review experience or experience with Utilization Review , Quality, ... Description A client of Insight Globals is looking for HEDIS RNs or LPNs for a partially remote contract...entry of medical records assigned by a Clinical Quality Lead nurse. Miles will be reimbursed for any travel.… more
- Actalent (Philadelphia, PA)
- Remote HEDIS LPN Abstractor Description: Position Purpose: Lead data collection and abstraction for company quality measures, including HEDIS , CMS, CHIPRA ... standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS and other measure sets in compliance with standards +… more
- Molina Healthcare (WI)
- …in healthcare quality data. + 4+ Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking, Interventions tracking for at ... **Job Description** **Job Summary** The Lead Analyst, Quality Analytics and Performance Improvement role...Analytics team. Designs and develops reporting solutions to assist HEDIS audit, rate tracking, and Identifying targeted Interventions and… more
- Molina Healthcare (Ypsilanti, MI)
- …where a clinician's perspective would be valuable to uncover process gaps or limitations. HEDIS / Quality Reporting + Performs the lead role in the coordination ... Quality Intervention / QI Compliance + Acts as a lead specialist to provide project-, program-, and / or...and preparation of the HEDIS medical record review… more
- Molina Healthcare (MI)
- …member and provider outreach. + Serves as operations subject matter expert and lead for Molina Plan quality improvement HEDIS operations using a defined ... implementation, monitoring, and oversight of all chart collection for HEDIS , or HEDIS -like projects, Risk Adjustment, Risk...effective operations that drive change. + Functions as key lead for clinical chart review /abstraction and team… more
- Molina Healthcare (ID)
- …in healthcare quality data. + 5+ Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking, Interventions tracking for at ... + 5+ Years of experience in Statistical Analysis and forecasting of trends in HEDIS rates to provide analytic support for quality, finance, and health plan functions… more
- CenterWell (Raleigh, NC)
- …and approved workflow and leaders as needed. Follows established guidelines/procedures.** ** Review and assess provider/member detail HEDIS data (care gap ... and develop practice specific strategies designed to improve Medicare quality measures ( HEDIS ) as well as Part D/Patient Safety and Patient Experience (CAHPS-HOS).… more
- Insight Global (Chicago, IL)
- Job Description The Lead Data Scientist/Engineer plays a pivotal role in supporting the Medicare Clinical Stars program by providing technical expertise in data ... support to enable data-driven insights for clinical stars initiatives. The Lead Data Engineer collaborates closely with data scientists, engineers, and stakeholders… more
- The Cigna Group (Sunrise, FL)
- **Role Summary** The Provider Performance Enablement Lead Analyst is a key member of the market that assists in the growth and development of the provider network. ... that represents Cigna Medicare Advantage. The Provider Performance Enablement Lead Analyst's responsibilities include: + Most likely to have responsibility… more
- University of Virginia (Charlottesville, VA)
- …optimizing workflows for capture of relevant clinical information. + Engage in periodic review of program data reflecting performance and outcomes. + Serve as team ... to develop relevant in-person and online educational trainings on priority HEDIS quality measures, complex diagnosis documentation for improved risk adjustment, and… more
- Elevance Health (Los Angeles, CA)
- …Information Set ( HEDIS ) improvement action plans, year round medical record review , and over read processes. + Monitors and reports quality measures per state, ... of quality management to direct the clinical quality initiatives, including HEDIS and CAHPS quality improvement, NCQA accreditation and compliance with regulatory… 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 PCP ... accountability, and passion. As a player/coach, the SMD will demonstrate and lead the center's providers towards: Accountability and oversight for outcomes: The SMD… more
- ERP International (Camp Pendleton, CA)
- …Population Health Program, including strategic marketing for specific audiences. * Review beneficiary data from DHB and current and previous analytical data ... * Work with the COR and NHCP/NMRTC Camp Pendleton PHP Government Lead to ensure effective contract management, fulfillment of deliverables, and management of… more
- Molina Healthcare (NM)
- …of these quality improvements functions: Quality Interventions, Quality Improvement Compliance, HEDIS , and / or Quality Reporting. Quality Intervention / QI ... Compliance + Acts as a lead specialist to provide project-, program-, and / or...care); preparation for Quality Improvement Compliance surveys; preparation and review of potential quality of care and critical incident… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …and ensure adequate training is available for documentation and coding best practices for HEDIS and risk adjustment. This role will have a positive impact on our ... practices. Partner with Coding Quality Educators to identify opportunities to review providers' medical records to better understand knowledge and performance gaps… more
- Sharp HealthCare (San Diego, CA)
- …in risk management reviews. + Assists in pharmacy utilization management, catastrophic case review , outreach programs, HEDIS reporting, site visit review ... services, and oversees the health care needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its' Chief Medical Officer.… more
- ERP International (Nellis AFB, NV)
- …by using MTF specific Quality Improvement processes to identify areas for review from data, suspected problem areas, and input from departments/services within the ... and continually evaluates the impact of implementation. Incorporates applicable utilization review tasks to ensure patients receive the appropriate level of care… more