• Medicare STARS Business

    CVS Health (Hartford, CT)
    …address reporting needs focusing on our complex business problems. The position supports Medicare Stars and our mission to provide data collection for all ... business area:** The Data Intelligence team supports the Medicare organization and the Stars program within...via strong partnerships with our customers and colleagues A Business Analytics intern will work with the… more
    CVS Health (11/16/24)
    - Save Job - Related Jobs - Block Source
  • Medicare Part D Stars

    The Cigna Group (Bloomfield, CT)
    **Summary** The Part D Stars Business Analytics Senior Advisor will be responsible for leading the analytics strategy for Cigna Healthcare within the ... Part D measures. This position is located within the Medicare Stars Analytics team, who's...support to internal and external partners to improve Cigna's Medicare Star Ratings. The Business Analytics more
    The Cigna Group (11/08/24)
    - Save Job - Related Jobs - Block Source
  • Business Analytics Advisor…

    The Cigna Group (Bloomfield, CT)
    **Summary** The Stars Business Analytics Advisor...Stars measures. This position is located within the Medicare Stars Analytics team, who's ... for Cigna Healthcare, performing research and analysis within the Medicare Stars program with a focus on...support to internal and external partners to improve Cigna's Medicare Star Ratings. The Business Analytics more
    The Cigna Group (10/29/24)
    - Save Job - Related Jobs - Block Source
  • Medicare Advantage Quality Consultant…

    Highmark Health (Harrisburg, PA)
    …across all the Organization's value-based programs for both the commercial and government business (ACA, Medicare STARS , Medicaid HEDIS, risk revenue). + ... is a highly skilled subject matter expert (SME) in Medicare STARS , Medicaid HEDIS and risk revenue...work with other functions in the provider area, data analytics , and key internal/external stake holders to provide the… more
    Highmark Health (11/14/24)
    - Save Job - Related Jobs - Block Source
  • Data Science Lead Analyst ( Medicare )…

    The Cigna Group (Franklin, TN)
    … Clinical and Customer strategy, performing research and analysis within the Clinical, STARS , and Risk Adjustment Analytics team. Reporting to the Senior Manager ... to make recommendations based on relevant findings. The Clinical, STARS , and Risk Adjustment Analytics team seeks...clinical programs, customer value, growth, and retention for Cigna Medicare . This role will help us accomplish this through… more
    The Cigna Group (09/28/24)
    - Save Job - Related Jobs - Block Source
  • Medicare Provider Performance Enablement…

    The Cigna Group (Atlanta, GA)
    …All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: **Growing ... organization (which includes Market Provider Performance, Sales, Clinical Operations, Stars & Risk Adjustment, Finance , Cross-Segment Contracting, Provider… more
    The Cigna Group (08/27/24)
    - Save Job - Related Jobs - Block Source
  • Medicare Advantage Risk Adjustment…

    UCLA Health (Los Angeles, CA)
    …Bachelor's degree in Health Care Administration, Public Health, Population Health, Finance, Business Analytics or related field and/or equivalent experience * ... * Five or more years of experience in healthcare analytics , strategy, and/or consulting at an IPA or health...experience * Knowledge of HIPAA regulations * Knowledge of Medicare Advantage, STARS /HEDIS program, and NCQA technical… more
    UCLA Health (10/25/24)
    - Save Job - Related Jobs - Block Source
  • Manager, Clinical Quality Analytics

    LA Care Health Plan (Los Angeles, CA)
    …and analytics on quality programs for all of LA Care's line of business (LOB) which includes Medicare Stars , Exchange Quality Rating Systems and ... Stars strategy and related activities. Act as an analytics and technical subject matter expert on teams working...Strong understanding of health care quality reporting programs, specifically Medicare Stars and HEDIS and health plan… more
    LA Care Health Plan (08/28/24)
    - Save Job - Related Jobs - Block Source
  • Lead Analyst, Data Quality Analytics

    Molina Healthcare (ID)
    **Job Description** **Job Summary** **_ This position will be focused on the Medicare STARS program. Please highlight your experience on your application. _** ... Medical Record Review tracking, Interventions tracking for at least one line of business among Medicaid, Marketplace and Medicare /MMP. + 5+ Years of experience… more
    Molina Healthcare (11/07/24)
    - Save Job - Related Jobs - Block Source
  • Health Outcomes Pharmacist

    Highmark Health (Wilmington, DE)
    …all of the Organization's value based programs for both the commercial and government business (ACA, Medicare STARS , Medicaid HEDIS, risk revenue). + ... strategies, Medication Therapy Management, utilization management, immunizations, specialty pharmacy, Medicare Stars , and Medicaid HEDIS to strategies designed… more
    Highmark Health (10/10/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Quality Program Manager III

    LA Care Health Plan (Los Angeles, CA)
    …expert (SME) on Clinical Quality programs, interventions and quality metrics related to Medicare Stars or Covered California QRS programs. These programs include ... metric sets. Skills Required: Thorough knowledge on health plan quality ratings including Medicare Stars and / or Marketplace Exchange Quality Rating Systems… more
    LA Care Health Plan (11/07/24)
    - Save Job - Related Jobs - Block Source
  • Provider Transformation Specialist (Southeaster…

    Highmark Health (Harrisburg, PA)
    …savings outcomes as a result of workflow transformation, superior coding accuracy, and Medicare STARS gap closure to providers based upon each individual ... for superior coding accuracy, cost and utilization reports, medical loss ratio reports, Medicare STARS gaps and other risk revenue opportunities. + Function as… more
    Highmark Health (11/08/24)
    - Save Job - Related Jobs - Block Source
  • Sr. Manager, National Patient Experience…

    CVS Health (Chicago, IL)
    …Senior Manager, National Patient Experience Performance you will be a member of the Medicare Stars National Patient Experience team. As the Senior Manager, you ... you will proactively identify areas for improvement and independently influence business leaders to drive behavior change through negotiation and consultation,… more
    CVS Health (11/16/24)
    - Save Job - Related Jobs - Block Source
  • Network Operations Senior Advisors, Provider…

    The Cigna Group (Bloomfield, CT)
    …All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: Growing ... organization (which includes Market Provider Performance, Sales, Clinical Operations, Stars & Risk Adjustment, Finance , Cross-Segment Contracting, Provider… more
    The Cigna Group (11/15/24)
    - Save Job - Related Jobs - Block Source
  • Staff VP, Quality Member Orchestration

    Centene Corporation (Tallahassee, FL)
    …and cloud based platforms + Work experience in health insurance/health care, Medicare Stars , strongly preferred + Experience in retail, e-commerce, consumer ... CX, service and clinical platforms needed to deliver on business results + Lead and enable implementation of seamless,...+ Direct the work of member orchestration, outreach, and analytics team to develop a centralized process to collect,… more
    Centene Corporation (11/15/24)
    - Save Job - Related Jobs - Block Source
  • Senior Manager Clinical Services

    Help at Home (Columbus, OH)
    …IT, Market and Area Leader, Branch Managers, and branch teams on data and analytics that drive quality and fiscally responsibility. + Works closely with the Market ... many people in achieving organizational goals and objectives. + Knowledge STARS quality measures, Quality Assessment and Performance Improvement program, Medicare more
    Help at Home (10/15/24)
    - Save Job - Related Jobs - Block Source
  • Provider Engagement, Clinical Quality Executive

    Humana (Oklahoma City, OK)
    …population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as they relate to ... Improvement initiatives and strategies + Experience using healthcare data and analytics to inform program development **Additional Information** This position is… more
    Humana (11/01/24)
    - Save Job - Related Jobs - Block Source