• Temporary Hedis Abstraction & Review

    Commonwealth Care Alliance (Boston, MA)
    011370 CCA-Population Health Strategy **Position Summary:** Reporting to the Manager of HEDIS or her/his delegate, the HEDIS Abstraction & Review ... quality controls for the HEDIS Medical Record Review . HEDIS ratings are one tool used...preferred + Medical Record Audit experience preferred (medical record review and capturing/ documenting appropriate clinical information… more
    Commonwealth Care Alliance (12/31/24)
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  • HEDIS Medical Record Specialist

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …He/she will assist the Program Manager in the training of all temporary HEDIS review staff and will provide direct supervision of temporary staff as needed ... HEDIS Medical Record Specialist will assist the Program Manager in preparing for the annual HEDIS ...training and education to physician and provider offices regarding HEDIS and clinical data abstraction requirements; +… more
    Blue Cross Blue Shield of Massachusetts (12/04/24)
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  • HEDIS Abstractor II (Temporary)

    LA Care Health Plan (Los Angeles, CA)
    HEDIS Abstractor II (Temporary) Job Category: Clinical Department: Quality Performance Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... enters data on HEDIS forms (tool) and over reads medical record review performed by vendors. All received medical record information is abstracted and entered… more
    LA Care Health Plan (01/09/25)
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  • Business Information Consultant Sr ( HEDIS

    Elevance Health (Mason, OH)
    **Business Information Consultant Sr ( HEDIS )** **Location:** This position will work a hybrid model (remote & office). The ideal candidate will live within 50 miles ... Health PulsePoint office locations. The **Business Information Consultant Sr ( HEDIS )** is responsible for coordinating and consolidating various impact analyses… more
    Elevance Health (01/08/25)
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  • Clinical Quality Data Analyst

    Medical Mutual of Ohio (Brooklyn, OH)
    …up to date knowledge and understanding of technical specifications for all HEDIS measures. Leads collaborative review of mapping documentation for annual ... a Subject Matter Expert to management and other departments.** **Leads collaborative review of mapping documentation for annual HEDIS Specification update… more
    Medical Mutual of Ohio (12/08/24)
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  • Manager Clinical Quality…

    Dignity Health (Bakersfield, CA)
    …is remote/work from home** **within California** **.** **Position Summary:** The Manager , Clinical Quality Improvement, is responsible for leading multiple ... for projects that are consistent with the organization's strategic goals. The Manager , Clinical Quality Improvement will oversee the day-to-day management of… more
    Dignity Health (11/13/24)
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  • Manager , Quality Data Reporting…

    VNS Health (Manhattan, NY)
    …support critical Quality Improvement functions (eg, Performance Improvement Projects, including HEDIS , state-based measure reporting and medical record review ). ... OverviewLeads and manages all aspects of data for the HEDIS /STARS/QARR/QIP functions, which includes but are not limited to, data collection and submission, quality… more
    VNS Health (01/07/25)
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  • Senior Program Manager , Government…

    Fallon Health (Worcester, MA)
    …and staff within Fallon Health to facilitate the design and implementation of clinical quality improvement activities and to support HEDIS submissions. In ... nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences,...**Compliance & Audit (40%)** * Serves as the Project Manager of the External Quality Review Organization… more
    Fallon Health (01/08/25)
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  • Behavioral Health Clinical Quality Audit…

    Elevance Health (Seven Fields, PA)
    …quarterly, annual and ad hoc medical record reviews such as ASAM monitoring, HEDIS and CPG compliance. + Prepares and sends formal written correspondence in ... and outreach interventions, provider education and outreach interventions, medical record review , focus studies and surveys. + Conducts quality of care… more
    Elevance Health (01/02/25)
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  • Manager Care Quality

    HCA Healthcare (Salt Lake City, UT)
    …provides satisfaction and personal growth, we encourage you to apply for our Manager Care Quality opening. We promptly review all applications. Highly qualified ... integrity. We care like family! Jump-start your career as a(an) Manager Care Quality today with MountainStar Healthcare. **Benefits** MountainStar Healthcare, offers… more
    HCA Healthcare (12/22/24)
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  • Senior Quality Improvement/Assurance Analyst

    Adelante (Phoenix, AZ)
    …Senior Quality Immunizations Program Analyst, Senior Quality Data Analyst, the Quality Improvement Manager and Safety and Clinical Risk Manager EXPECTATIONS ... in collaboration with SQIDA + Collaborate with Quality Improvement Manager to create, review progress and update...+ Collect and analyze data related to: + UDS, HEDIS + Quality metrics + Clinical audits… more
    Adelante (12/12/24)
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  • Pharmacy Medicaid Manager (Hybrid)

    CareFirst (Owings Mills, MD)
    …of the Director of Government Programs Pharmacy Services. The Medicaid Pharmacy Manager is also responsible for providing clinical expertise relative to ... the pharmacy benefit programs, participating in designing, developing, and implementing clinical programs to promote a quality cost-effective medication use and… more
    CareFirst (12/21/24)
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  • Government Business Quality Management Health Plan…

    Elevance Health (Los Angeles, CA)
    …for working with the regional head of quality management to direct the clinical quality initiatives, including HEDIS and CAHPS quality improvement, NCQA ... Information Set ( HEDIS ) improvement action plans, year round medical record review , and over read processes. + Monitors and reports quality measures per state,… more
    Elevance Health (01/09/25)
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  • Medical Assistant Apprentice

    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
    Sea Mar Community Health Centers (12/12/24)
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  • Senior Medical Director - Sharp Health Plan

    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 (10/20/24)
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  • Specialist, Quality Management (Remote in Arizona)

    Molina Healthcare (AZ)
    …quality management compliance activities. Please make sure to include any healthcare/ HEDIS /quality metric experience on your resume. We are moving quickly to ... and results to identify opportunities for improvement. * Monitors and collaborates with Manager and Director to address any gaps in processes that may require… more
    Molina Healthcare (12/29/24)
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  • Practice Management Analyst

    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
    Johns Hopkins University (10/30/24)
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  • Associate Medical Director

    CenterWell (Mesa, AZ)
    …Medical Director is also responsible for administrative oversight and outcomes for clinical providers designated to their area. Keeps a medical history and medical ... time dedicated to administrative duties related to oversight of clinical provision of care in their area. + .Requires...perspective of the market. + Assist in Ongoing Chart Review monitoring. + Assist with recruitment and interviewing as… more
    CenterWell (12/24/24)
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  • Float LPN

    CenterWell (Columbia, SC)
    …histories in electronic medical records software + Phone Triage using critical clinical judgement. + Delivering results to patients as providers direct. + Performing ... screened for TB. + Excellent customer service + Strong clinical background + The ability to adapt and work...+ Experience with Electronic Medical Records + Experience with HEDIS + Knowledge of primary care medicine requirements (state… more
    CenterWell (12/21/24)
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  • Medical Assistant CenterWell

    CenterWell (The Villages, FL)
    …put health first** As a Medical Assistant, you will be a part of the Clinical Care Team engaging with our patients to develop lifelong well-being and health. The ... are multiskilled health professionals responsible for performing administrative and clinical tasks in our primary care facilities while delivering outstanding… more
    CenterWell (01/07/25)
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