• Senior HEDIS Medicaid Data Manager

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Senior Data Manager supports all aspects of configuration control, data management, ... Quality and Stars organization is seeking a Senior HEDIS Data Manager to deliver quality and...millions of people we serve to achieve their best health - delivering the care and service… more
    Humana (11/22/24)
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  • Sr Analyst, HEDIS /Quality Reporting…

    Molina Healthcare (MI)
    …improvement experience. + 1+ years in managed healthcare non-financial reporting. + 1+ years health care information systems experience or in a role as an IS ... QI compliance activities. **Candidates residing in Michigan with SQL, Quality/ HEDIS and Health plan experience are strongly...to completion + Works with Director and / or Manager to establish and / or document quality assurance… more
    Molina Healthcare (10/20/24)
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  • Clinical Quality Program Manager III

    LA Care Health Plan (Los Angeles, CA)
    …Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state ... Clinical Quality Program Manager III Job Category: Clinical Department: Quality Improvement...Care 's mission is to provide access to quality health care for Los Angeles County's vulnerable… more
    LA Care Health Plan (11/07/24)
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  • Manager , Clinical Quality Analytics

    LA Care Health Plan (Los Angeles, CA)
    health care quality reporting programs, specifically Medicare Stars and HEDIS and health plan regulatory reporting requirements. High degree of initiative ... Manager , Clinical Quality Analytics Job Category: Clinical Department:...$152,762.00 (Mid.) - $188,015.00 (Max.) Established in 1997, LA Care Health Plan is an independent public… more
    LA Care Health Plan (08/28/24)
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  • Manager , Transitional Care

    Trinity Health (Boise, ID)
    …Full time **Shift:** Day Shift **Description:** **GENERAL SUMMARY AND PURPOSE:** The Population Health and Transitional Care Manager of Population Health ... (CCM) exam in 1 year of hire date. Quality (STARs/ HEDIS ). **ESSENTIAL FUNCTIONS:** Knows, understands, incorporates, and demonstrates the...and clinic staff; will work closely with the population health transitional care manager lead.… more
    Trinity Health (11/20/24)
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  • Quality Improvement (RN) - Maternity (OB/GYN)

    Molina Healthcare (Ypsilanti, MI)
    …Min. 3 years' experience in healthcare with minimum 2 years' experience in health plan quality improvement, managed care , or equivalent experience. **Required ... + 2 years coding and medical record abstraction experience. + 1-year managed care experience. + Basic knowledge of HEDIS and NCQA. **Preferred License,… more
    Molina Healthcare (10/20/24)
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  • Senior Medical Management Nurse - VCHCP

    Ventura County (Ventura, CA)
    …in a Managed Health Care Plan; + Experience working as a case manager in a health plan case managing complex cases; + Demonstrated experience in the ... Job Type Full-Time Regular Job Number 0231HCA-24AC (BR) Department Health Care Agency Opening Date 08/06/2024 Closing...HEDIS measures and standards. + Experience utilizing the care planning process as part of the case management… more
    Ventura County (11/12/24)
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  • Program Manager II - Healthcare

    Centene Corporation (Richmond, VA)
    …maximizing opportunity to improve outcomes for members. 3 years of experience in QI, HEDIS PM or health care related experience. Working knowledge of ... in related field or equivalent experience. 3+ years of project management. Health care experience preferred. **Position Purpose:** Coordinate with teams to… more
    Centene Corporation (11/23/24)
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  • Clinical Quality Program Manager

    Elevance Health (Miami, FL)
    …Leads plan level HEDIS strategy to drive improvement in behavioral health HEDIS measures, ensuring achievement in performance guarantees and/or service level ... **JR131500 Clinical Quality Program Manager ** Responsible for serving as a liaison with...nursing, or a related clinical field; 4 years of health care quality or data analysis experience;… more
    Elevance Health (11/16/24)
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  • Supervisor, Transitional Care Services

    LA Care Health Plan (Los Angeles, CA)
    care setting, such as a health insurance environment and/or experience as care manager in hospital or home health environments. At least 2 years ... $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, LA Care Health Plan is an independent public...as demonstrated through identifying clinical priorities and outcomes (eg HEDIS , etc.). Assist in the development and implementation of… more
    LA Care Health Plan (10/26/24)
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  • Quality Improvement Manager

    Praxis Health (OR)
    …to improve healthcare outcomes. Minimum Qualifications + Bachelor's degree in health care administration, Business Administration, Health Administration, ... You'll Do: + Lead and manage a team of HEDIS reviewers with clear goals and performance metrics. +...healthcare companies in Oregon. We are not "big box" health care , but rather a company of… more
    Praxis Health (11/20/24)
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  • Provider Engagement Account Manager

    Centene Corporation (Tigard, OR)
    …performance + Drives provider performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + ... relations to ensure delivery of the highest level of care to our members. Engage with providers to align...Project management experience at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures,… more
    Centene Corporation (11/17/24)
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  • Government Business Quality Management…

    Elevance Health (Los Angeles, CA)
    …(CMS), and accrediting requirements. **Minimum Requirements:** Requires BA/BS in a clinical or health care field (ie nursing, epidemiology, health sciences) ... and a minimum 5 years progressively responsible experience in a health care environment or any combination of education and experience, which would provide an… more
    Elevance Health (10/12/24)
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  • Senior Manager , Practice Innovation

    University of Virginia (Charlottesville, VA)
    …Skills & Abilities)** **:** **Education and Licensure:** + Bachelor's Degree in Health Care Administration, Business Administration, Nursing, or related degree. ... improvement initiatives impacting core clinical processes and critical patient care functions. Works collaboratively with executive leadership, administrators, managers… more
    University of Virginia (11/07/24)
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  • Clinic Manager - North Buckner

    CenterWell (Dallas, TX)
    …of senior-focused primary care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on ... CenterWell is a subsidiary of Humana, seeking a Primary Care Clinic Manager , that develops and leads...address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health more
    CenterWell (11/19/24)
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  • Senior Population Health Specialist

    Beth Israel Lahey Health (Wakefield, MA)
    …Under the supervision of the Quality Manager , the Senior Population Health Specialist (PHS) supports collaboration, communication and care coordination with ... all members of the health care team, including but not limited to practices, clinicians,...engagement, and training/education design and implementation. 10. Coordinates with Manager of Quality for Population Health Specialist… more
    Beth Israel Lahey Health (11/13/24)
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  • VBC Program Manager WFH

    HCA Healthcare (Nashville, TN)
    …Do you want to join an organization that invests in you as a VBC Program Manager WFH? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 ... Zone. **Benefits** HCA Healthcare offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
    HCA Healthcare (11/13/24)
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  • Nurse Manager (RN or LPN)

    Sea Mar Community Health Centers (Tacoma, WA)
    …(NCQA) as a Patient Centered Medical Home (PCMH) level III. The Nurse Manager works in conjunction with Health Center Administrator and Clinical Director ... Sea Mar Community Health Centers, a Federally Qualified Health ...is a mandatory COVID-19 and flu vaccine organization Nurse Manager - Posting #25738 Salary Rate: $74,958.09 (LPN) -… more
    Sea Mar Community Health Centers (10/30/24)
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  • Nurse Manager (RN or LPN)

    Sea Mar Community Health Centers (Puyallup, WA)
    …They will know the Social Determinants of health , what that means in Community Health Care , and how that is different from other health care ... Patient Centered Medical Home (PCMH) level III. The Nurse Manager works in conjunction with Health Center...or hospitals + Focus clinic efforts on quality measures, HEDIS , and Meaningful Use standards + Provide annual MA… more
    Sea Mar Community Health Centers (11/13/24)
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  • Manager Clinical Quality Improvements

    Dignity Health (Bakersfield, CA)
    …across provider types and geographies and will lead the effort in developing Dignity Health 's Medicaid population health care management pathways. Dignity ... (LCSW), NP, PA,). - 5 years of Quality Management (QM) experience in managed care health plan setting or medical group. - 5 years of… more
    Dignity Health (11/13/24)
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