- Molina Healthcare (Paducah, KY)
- …Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. + Mentor entry and Sr. level abstractors. + Works ... lead role in the coordination and preparation of the HEDIS medical record review which includes ongoing...vendors for the medical record collection process. + Assists Manager and Supervisor(s) in training, utilizing the standardized training… more
- 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
- Molina Healthcare (Ypsilanti, MI)
- …Quality Reporting + Performs the lead role in the coordination and preparation of the HEDIS medical record review which includes ongoing review of records ... quality strategies that require a component of near real-time clinical decision-making. These activities may include initiation and management...submitted by providers and the annual HEDIS medical record review . The Senior Specialist… more
- Ventura County (Ventura, CA)
- …years of full-time experience in Case Management, Disease Management, Quality Assurance, HEDIS and/or Utilization Review . NECESSARY SPECIAL REQUIREMENTS + Must ... Utilization Management and tasks related to Healthcare Effectiveness Data and Information Set ( HEDIS ) as well as writing reports and analyses in line with the… more
- University of Virginia (Charlottesville, VA)
- … clinical outcome measures, and optimizing workflows for capture of relevant clinical information. + Engage in periodic review of program data reflecting ... for leading and managing quality improvement initiatives impacting core clinical processes and critical patient care functions. Works collaboratively with… more
- Elevance Health (Seven Fields, PA)
- …and outreach interventions, provider education and outreach interventions, medical record review , focus studies and surveys. + Performs monthly, quarterly, annual ... and ad hoc medical record reviews such as HEDIS and CPG compliance. + Conducts quality of care...appropriately or refers to BH Medical Director for further review . + Prepares cases for Peer Review … more
- Penn Medicine (Bala Cynwyd, PA)
- …improving workplace safety in the practices. + Responsible for the creation, review , revision and communication of clinical /safety related policies. + Performs ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- The Cigna Group (Bloomfield, CT)
- …manage relationships with participating provider practices. Maintain detailed understanding of HEDIS / STAR performance measures. Develop and maintain a process to ... care services in conjunction with the physician treatment plan. Utilizes clinical skills to assess, plan, implement, coordinates, monitor and evaluates options… more
- Tufts Medicine (Burlington, MA)
- …business experience. 2. Four (4) years of healthcare management or clinic manager experience working directly with physicians and practice members with a ... in primary care. 2. Experience with and knowledge of HCC/RAF, PCMH, HEDIS /Quality. **Duties and Responsibilities:** The duties and responsibilities listed below are… more
- Fallon Health (Boston, MA)
- …rated among the nation's top health plans for member experience, service, and clinical quality. Fallon Health's NaviCare is a program for people age 65 and ... and LinkedIn** **Brief Summary of Purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary...providers and office staff and may lead care plan review with providers and care team as applicable +… more
- Elevance Health (Buffalo, NY)
- …for working with the regional head of quality management to direct the clinical quality initiatives, including HEDIS and CAHPS quality improvement, NCQA ... in developing, monitoring, and evaluating Healthcare Effectiveness Data Information Set ( HEDIS ) improvement action plans, year-round medical record review , and… 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 ... center, as the true dyad partner to the Center Manager /Center General Manager . Directly supervise, performance manage...VIP service, standards of care and quality guidelines, and HEDIS /STARS + Inspire seamless coverage of clinical … more
- ERP International (Camp Pendleton, CA)
- …communication strategies. * Collaborate with the Healthcare Effectiveness Data and Information Set ( HEDIS ) Clinical Quality Teams on a monthly basis to evaluate ... Population Health Program, including strategic marketing for specific audiences. * Review beneficiary data from DHB and current and previous analytical data… more
- Sea Mar Community Health Centers (Aberdeen, WA)
- …all relative clinic forms, quality/ HEDIS measures, lab and x-ray reports and review of the Patient Manager and Medication confirmation process and any ... month program that prepares students to take the Certified Clinical Medical Assistant (CCMA) test through the National Health...non-compliance should be reported immediately to the supervisor / manager . + Assists providers with GYN exams, I &… more
- CenterWell (Oviedo, FL)
- …first** As a Medical Assistant/Phlebotomist, you will be a part of the Clinical Care Team engaging with our patients to develop lifelong well-being and health. ... are multiskilled health professionals responsible for performing administrative and clinical tasks in our primary care facilities while delivering outstanding… more
- Sharp HealthCare (San Diego, CA)
- …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. ... in risk management reviews. + Assists in pharmacy utilization management, catastrophic case review , outreach programs, HEDIS reporting, site visit review … more
- Sharp HealthCare (San Diego, CA)
- …and accurate manner. Partners with physicians to continuously learn and expand clinical knowledge base.In partnership with physician, may review pre-printed ... in clinical projects as directed by the lead, supervisor, manager , or SCMG administration. + Department Efficiency and EffectivenessProvides accurate information… more
- Sharp HealthCare (San Diego, CA)
- …in clinical projects as directed by the lead, supervisor, manager or SCMG Administration. + Department Efficiency and Effectiveness Provides accurate information ... This position supports the Sharp Community Medical Group (SCMG) Population Health- Clinical Quality team by the effective coordination and maintenance of performance… more
- ERP International (Nellis AFB, NV)
- …admissions, including all eligible beneficiaries, to civilian hospitals and notifies Clinical Nurse Case Manager and Patient Administration Element as ... by using MTF specific Quality Improvement processes to identify areas for review from data, suspected problem areas, and input from departments/services within the… more
- Johns Hopkins University (Baltimore, MD)
- …on data analytics projects and initiatives from the Business Analytics and Clinical Data Program Manager . **Specific Duties & Responsibilities** _Ambulatory ... on improving operations and communication amongst the practices. + Participate in the review of PQRS, HEDIS , Value Based Purchasing and other population health… more
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