- Signature HealthCARE (Nashville, TN)
- …caretakers, families, and multidisciplinary treatment teams, fostering communication and teamwork to provide the highest quality of care for residentsWhat you ... cognitive care, and telemedicineA growing number of our centers are earning quality assurance accreditation and pioneering person - directed careMany of our skilled… more
- Signature HealthCARE (Nashville, TN)
- …of clinical care that meet state/federal regulations to promote excellence in care and quality of life for each resident. Provide oversight and guidance to staff ... 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded...based on program requirements with segment teams. Analyze toolbox data , including facilities past performance surveys and quality… more
- Signature HealthCARE (Clarksville, TN)
- …of resident centered healthcare services, personalized spirituality, and real quality of life initiativesSignature HealthCARE is a family-based healthcare company ... cognitive care, and telemedicineA growing number of our centers are earning quality assurance accreditation and pioneering person - directed careMany of our skilled… more
- The Cigna Group (Nashville, TN)
- …The Data Governance & Ownership (DG&O) Senior Manager will work with the Provider Data Quality & Accuracy (PDQA) Director to establish the framework ... to ensure delivery of operational excellence. + Monitoring of provider data quality and accuracy...Establish and track KPIs to measure the effectiveness of data governance initiatives. Provide regular reports to… more
- The Cigna Group (Nashville, TN)
- **Summary** The Provider Data Quality &..._###@cigna.com_ _for an update on your application or to provide your resume as you will not receive a ... data cleansing algorithms and processes. + Communicate data quality findings and recommendations to both...through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.… more
- BlueCross BlueShield of Tennessee (Nashville, TN)
- …the quality program\. + Implement strategy for HEDIS/STARS supplemental data collection and oversees staff associated with this effort\. + Perform forecasting, ... a staff that will educate and execute the strategy and vision related to provider engagement + Oversee functions related to MA provider education, engagement and… more
- The Cigna Group (Nashville, TN)
- …critical processes + Develop reporting in collaboration with analytics partners to monitor data quality + Work effectively and efficiently on multiple tasks and ... **Summary** The Medicare Risk Adjustment Advanced Analytics team is searching...while producing high quality results + Ensure quality and integrity of data and follow… more
- Elevance Health (Nashville, TN)
- **Audit & Reimbursement Senior -** ** Medicare Cost Report Audit** **Locations:** _This is a United States based, virtual position._ **National Government Services** ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...Standards (GAS) and CMS requirements. + Analyze and interpret data with recommendations based on judgment and experience. +… more
- Humana (Nashville, TN)
- …Health Medical Director will attend and participate in meetings involving care management, provider relations, quality of care, audit, grievance and appeal and ... to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- The Cigna Group (Nashville, TN)
- …experience in healthcare analytics; value-based care experience preferred + Experience with government medicare data highly desired + Data extraction and ... quality of care of our members by our provider groups. In addition, this person will be responsible...collaboratively with key technical and non-technical matrix partners to provide analytical reporting for use in evaluation of our… more
- The Cigna Group (Nashville, TN)
- …tasks and deadlines, while producing high quality results + Ensure quality and integrity of data collected and analyses performed **Qualifications** + ... **Summary** The Medicare Risk Adjustment Analytical Consulting team is searching...business analytics advisor to identify key analytics needs and provide insights which address business questions and influence decision-making.… more
- The Cigna Group (Nashville, TN)
- …Cigna's Medicare PDP growth goals. **Responsibilities** + Partner to provide the strategic direction and management of digital acquisition marketing initiatives ... in driving marketing strategy and initiatives with a strong focus on data -driven decision-making and a deep understanding of digital marketing. Additionally, will be… more
- Prime Therapeutics (Nashville, TN)
- …mining and analyses to help investigate and answer challenging questions regarding actuarial data and concepts + Provide strategic pricing advice on structures ... decision we make. **Job Posting Title** Principal Actuary - Medicare Part D - Remote **Job Description** The Principal...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- The Cigna Group (Nashville, TN)
- …evaluate the cost and quality of care of our members by our provider groups. In addition, this person will be responsible to identify opportunities for our ... collaboratively with key technical and non-technical matrix partners to provide analytical reporting for use in evaluation of our...quality of care opportunities for a variety of provider groups in a value-based care arrangement + Extract,… more
- Highmark Health (Nashville, TN)
- …and authority. + Develop, implement and execute, the Provider STARs quality strategy, support/develop technology and data strategies to support STARs ... Responsibilities include but are not limited to the overall field facing STARs Provider Strategy, supporting and developing technology and data strategies to… more
- Humana (Nashville, TN)
- …rotations through various DVACO departments including Care Coordination, Practice Transformation, Data Analytics, Post-Acute Care and Clinical Quality , and the ... Fellow can tailor their experience through various projects in quality oversight, data reporting, performance improvement, physician...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Humana (Nashville, TN)
- … relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, ... community and help us put health first** The Supervisor, Provider Engagement develops and grows positive, long-term relationships with...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Centene Corporation (Nashville, TN)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/ quality , cost and utilization, etc. Evaluates provider performance and ... respond to external provider related issues + Investigate, resolve and communicate provider claim issues and changes + Initiate data entry of provider… more
- Humana (Nashville, TN)
- …with data analytics teams to use insights in enhancing provider visibility and member decision-making + Manage the product backlog, prioritize features ... us put health first** The Lead Product Manager - Provider Directory helps identify, validate, and implement improvements to...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Humana (Nashville, TN)
- …and Reporting Professional's primary role is to develop organized analytics, reports and data management to support the market's Quality team within the Medicaid ... community and help us put health first** The Senior Data and Reporting Professional generates ad hoc reports and...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
