- Robert Half Accountemps (Minneapolis, MN)
- …individuals with expertise and experience in many areas of risk adjustment and quality improvement , including HEDIS (R), CAHPS and Accreditation. Our goal ... Description Do you have HEDIS experience? Join a Fortune 500 Healthcare company...immediately + Performs medical record reviews for risk adjustment, HEDIS (R) and HEDIS (R)-like measures via remote EMR… more
- Centers Plan for Healthy Living (Garden City, NY)
- …A minimum of three (3) years of experience in the health care industry, in HEDIS and/or quality improvement . Experience in a managed care health services ... Living (CPHL) under the direction of the Director of Quality Management. Responsibilities include, but are not limited to...secure clinical documentation from Primary Care Physician (PCP) and/or Specialist (s) as indicated by HEDIS measures. +… more
- VNS Health (Manhattan, NY)
- …providers or specialist to address non-adherence and/or clinical diagnosis for HEDIS /QARR exclusion. + Participates and leads improvement teams and projects ... OverviewLeads interdepartmental quality improvement activities such as development and engagement, clinical review, clinical risk management, and patient… more
- Centene Corporation (Baton Rouge, LA)
- …of Case Management. **Position Purpose:** Plan, develop and track process improvement and operational projects related to clinical outcomes for products and ... for all clinical initiatives including, case and disease management, behavioral health and HEDIS outcome measures + Evaluate the analysis and responses on all … more
- Molina Healthcare (Columbus, OH)
- …and implementation of NCQA accreditation surveys and federal/state QI compliance activities. ** Quality Improvement , HEDIS , Healthcare experience is very ... functions: Quality Interventions and Quality Improvement Compliance. + Acts as a lead specialist...be preferred for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
- Molina Healthcare (Edinburg, TX)
- **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement ... , Quality Interventions/ QI Compliance contributes to one or more of these quality improvement functions: Quality Interventions and Quality … more
- AdventHealth (Westwood, KS)
- …CMS, HEDIS etc) . Support and maintain outreach initiatives and other quality improvement strategies . Answers questions and provides clear instructions to ... ** Quality Measure Specialist -AdventHealth** **All the benefits and perks you need for you and your family:** . Benefits from Day One . Paid Days Off from Day… more
- Elevance Health (Olathe, KS)
- … Program Specialist ** is responsible for supporting projects and assisting the quality improvement activities and programs for and/or on behalf of the Health ... met within established time frames and budgets. + Assists with compliance of corporate Quality Improvement (QI) work plans. + Supports Clinical Quality … more
- Health First (Rockledge, FL)
- …status for organizational providers. 9. Conduct reviews of provider network adequacy for quality improvement evaluation, the National Committee for Quality ... *POSITION SUMMARY* The Provider Network Credentialing Specialist is responsible for coordinating, monitoring and maintaining the credentialing and re-credentialing… more
- Molina Healthcare (NM)
- …, Provider Engagement contributes to one or more of these quality improvement functions: * Acts as a lead specialist to provide project-, program-, ... **Job Summary** Molina's Quality Improvement function oversees, plans, and...(RN may be preferred for specific roles) * Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
- Robert Half Office Team (St. Paul, MN)
- …data collection cycle within Retrieval Operations, which focuses on risk adjustment and quality improvement . In this role, you will collaborate with the ... Description The Retrieval Specialist will play a vital role in the...immediately. + Review medical records for risk adjustment and HEDIS (R)-related measures via remote EMR access or onsite visits.… more
- Sharp HealthCare (San Diego, CA)
- …oversees education and communication with providers related to quality improvement and outreach initiatives, including screenings, HEDIS , health fairs, ... market issues, provider reputations, provider strengths and weaknesses, provider quality , availability, and referral source patterns, by establishing a personal… more
- Centene Corporation (Omaha, NE)
- …orientations and conduct ongoing educational outreach with a focus on improving quality and financial outcomes within the provider network. Act as liaison between ... HBR (Health Benefits Ratio) analyses, Health Information data Information Set ( HEDIS ) analyses, and create reports for provider Review provider performance by… more
- Highmark Health (Harrisburg, PA)
- …7 years in Medicare + 5 - 7 years in Managed Care Support + 3 - 5 years in Quality Improvement + 3 - 5 years in Care Management + 3 - 5 years in Utilization ... in quality , cost, and utilization scores, identifies opportunities for improvement in value creation, cost control and utilization, performance, and develops… more
- ChenMed (Philadelphia, PA)
- …needs. + Manages clinical teams to deliver VIP service, standards of care and quality guidelines, and HEDIS /STARS + Inspire seamless coverage of clinical staff ... at RCMO's discretion, which may include: + Assists RCMO with region quality , medical cost efficiency, and performance improvement initiatives. + Oversees… more
- St. Luke's Health System (Boise, ID)
- …St. Luke's Health System in Boise, ID is seeking a Network Performance Improvement Specialist to join our Health Partners team. Under moderate direction, ... the Network Performance Improvement Specialist identifies performance improvement ...+ Has proficient and comprehensive knowledge of performance measures ( HEDIS , quality , utilization, cost, care coordination, etc.),… more
- Corewell Health (Southfield, MI)
- …standards, conducting PDSA, Cycle Time analysis, Process Mapping, Gap analysis, and facilitate quality improvement . + Lead liaison between the team and ACO data ... and tactics across the ambulatory environment. The Program Coordinator II works to drive improvement in health outcomes, quality of care, experience of care, as… more
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