- The Cigna Group (Philadelphia, PA)
- **Job Summary:** The Stars and Risk Adjustment Operations Senior Advisor will report to the Stars and Risk Adjustment Managing Director and will be ... leadership. + Regularly monitor performance to goals though collecting data to report status on Stars and...meeting cadence. Schedule, draft agenda and gather materials for Stars and RA team meetings and Medicare … more
- The Cigna Group (Philadelphia, PA)
- **Summary** The Data Scientist Lead Analyst will contribute to the Medicare Clinical and Customer strategy, performing research and analysis within the Clinical, ... , and Risk Adjustment Analytics team. Reporting to the Senior Manager of Clinical & Customer Data ...to make recommendations based on relevant findings. The Clinical, STARS , and Risk Adjustment Analytics team seeks to provide… more
- The Cigna Group (Philadelphia, PA)
- **Summary** The Medicare Advantage Clinical Analytics team's mission is to provide operational and analytical support to our partners, promote sustained revenue ... growth and management, and improve customer value and affordability for Cigna Medicare . The Clinical Programs Analytics Manager is an opportunity to lead complex… more
- The Cigna Group (Philadelphia, PA)
- …an opportunity to lead complex analytics projects and initiatives for Cigna's Medicare Advantage Risk Adjustment business. The Manager will work collaboratively with ... business analytics work groups, such as STARs , Clinical, and analytics engineering, to transform ideas into...a team of business analytics professionals. Reporting to the Senior Manager of Risk Adjustment Analytics, this position will… more
- Humana (Harrisburg, PA)
- …of variable factors. Humana's Health Quality and Stars organization is seeking a Senior HEDIS Data Manager to deliver quality and value in a fast-paced, ... caring community and help us put health first** The Senior Data Manager supports all aspects of...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Highmark Health (Harrisburg, PA)
- …facing STARs Provider Strategy, supporting and developing technology and data strategies to support STARs performance, and developing provider incentive ... stakeholders, vendors and various cross-functional teams, locations and departments to improve Stars and/or Quality Rating outcomes for Medicare Advantage across… more
- Insight Global (Coraopolis, PA)
- …for a large health insurance client of ours. This individual will focus on evolving the Stars Data Engine to a new Ecosystem that allows for expanding our ... data ingestion footprint while increasing data security,...Framework to support the constituent needs of the various Medicare Business units. The individual will help manage the… more
- Humana (Harrisburg, PA)
- …life of our members by transforming data into advanced analytic solutions. The Stars program is the Centers for Medicare & Medicaid Services (CMS) five‐star ... the department this role is a part of, uses data science, business intelligence and Stars expertise...quality rating system for measuring Medicare beneficiaries' experience with their health plans and the… more
- 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 ... gain/risk share contracts and is strategically focused on those data gaps that will result in the greatest ROI...accuracy, cost and utilization reports, medical loss ratio reports, Medicare STARS gaps and other risk revenue… more