- Humana (Little Rock, AR)
- …systems readiness, process improvements, resource deployment, technology implementation, and data management/reporting. The Senior HEDIS Operations ... Humana's Health Quality and Stars organization is seeking a Senior Data Quality/Integrity Engineer to deliver quality...and Risk Adjustment, as well as vended partners. The Senior HEDIS Operations & Quality Professional supports… more
- Molina Healthcare (OH)
- …skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis, and/or ... intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions… more
- Humana (Louisville, KY)
- …health outcomes, optimized cost performance and measurable program value across Medicaid . This executive leverages advanced analytical, data science, and ... caring community and help us put health first** The Vice President, Medicaid Clinical Economics & Quality provides strategic and operational leadership for clinical… more
- Molina Healthcare (Columbus, OH)
- …corresponding tracking of progress and impact of such interventions. + Assist retrospective HEDIS rate tracking and supplemental data impact reporting. + Develop ... automated analytical as well as Reporting modules related to Quality/ HEDIS for Medicaid , Marketplace and Medicare/MMP. +...Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS… more
- Humana (Gainesville, FL)
- …planning. Reviews and communicates results of programs. + Provider non-standard supplemental data trending + Provider level HEDIS in service + Develop ... visits up to 40% of the time and is not fully remote. The Senior Stars Improvement, Clinical Professional (RN) is responsible for the development, implementation and… more
- Humana (Dunedin, FL)
- …remote with travel to provider offices within region The Quality Improvement Senior Clinical Professional (RN) is responsible for the development, implementation and ... region (Clearwater, St. Petersburg, Palm Harbor, Dunedin) The Quality Improvement Senior Clinical Professional (RN) develops programs designed to increase the plan… more
- Humana (Little Rock, AR)
- …a part of our caring community and help us put health first** As a Senior Network Performance Professional at Humana, you will play a pivotal role in enhancing ... as an expert on the Stars/Quality program, educating physician groups on HEDIS , patient safety, and patient experience. Collaborate to develop tailored action plans… more
- Adecco US, Inc. (Minneapolis, MN)
- …years in business analysis and data analysis (preferably in HEDIS , provider data , claims data , or Medicare/ Medicaid ). * 2+ years in business analysis ... Adecco is currently assisting a local Customer in their search for Senior Business Analyst in Remote. This is a great opportunity to further your existing skills as… more
- Fallon Health (New Bedford, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... and nursing assessment skills, may complete NaviCare Program Assessment Tools and Minimum Data Set Home Care (MDS HC) Form when a member's medical/functional status… more
- Molina Healthcare (Rockford, IL)
- …**Preferred Experience** + 1 year of experience in Medicare and in Medicaid . + Experience with data reporting, analysis and/or interpretation. **Preferred ... programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities;… more
- Humana (Helena, MT)
- …and HEDIS quality measures. The ideal candidate has deep expertise in Stars/ HEDIS data , regulatory requirements, and agile product development, and 3 tier ... Define and maintain the vision, strategy, and roadmap for data products that enable CMS Stars and HEDIS...projects or programs + Proficiency in understanding Healthcare related data + Proficiency in verbal/written communication to senior… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization to develop sophisticated ... strategic planning, decision-making, goal setting, and effective performance measurement. The Data Science Analyst III demonstrates sound and a more advanced… more
- CenterWell (Jupiter, FL)
- …health + HEDIS and Stars performance + Operational improvements + Data sharing and connectivity + Documentation and coding + Additional areas related to ... for the development, implementation and management oversight of the company's Medicare/ Medicaid Stars Program. The Stars Improvement, Clinical Professional 2 work… more
- CenterWell (North Charleston, SC)
- …for the development, implementation and management oversight of the company's Medicare/ Medicaid Stars Program. The Quality RN Professional work assignments are ... across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial performance and… more
- CenterWell (Hampton, VA)
- …for the development, implementation and management oversight of the company's Medicare/ Medicaid Stars Program. The Stars Improvement, Clinical Professional 2 work ... across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial performance and… more
- Commonwealth Care Alliance (Boston, MA)
- …Manager leads performance evaluation and improvement efforts, including reporting and data analysis, to ensure delegated entities meet contractual, regulatory, and ... full management responsibility for all performance measure components, including end-to-end data collection, evaluation, and timely dissemination of reports to both… more
- CVS Health (Columbus, OH)
- …and guidance to the health plan and external partners for the state Managed Medicaid pharmacy benefit. The Pharmacy Director reports to the Senior Lead Pharmacy ... and regulations pertaining to both pharmacy practice laws and Managed Medicaid /PBM regulations. The Pharmacy Director stays updated on changing regulations,… more
- CenterWell (Surprise, AZ)
- …and Medicare/ Medicaid provider numbers or ability to obtain DEA license and/or Medicaid and Medicare numbers. + Familiarity with HEDIS quality indicators and ... to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Join...evaluation of variable factors. Join a Team That's Redefining Senior Primary Care: Humana's Primary Care Organization is one… more
- CommonSpirit Health (Phoenix, AZ)
- …VP of Physician and Clinical Enterprise, the director collaborates closely with senior leadership including the CEO, COO, VP of analytics, and Compliance leadership. ... a multidisciplinary team encompassing system analysts, IT support specialists, data integration engineers, application developers, architects, and vendor partners to… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …(CMS, department of health, etc) and consulting companies. * Experience leading HEDIS data collection and submissions. * Knowledge of statistical software ... a high performing team responsible for the execution and day-to-day management of data submissions for ACA Commercial, Medicare, and Medicaid risk adjustment and… more