- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …Demonstrates clinical proficiency with healthcare performance measures including HEDIS, Medicare Stars , Pharmacy Quality Alliance (PQA) and Medicare specific ... the Quality Improvement Program, related work plans, quality activities, HEDIS, and STARS . This leader will develop, implement and monitor all quality assurance and… more
- Dignity Health (Sacramento, CA)
- …the pharmacy and within interdisciplinary teams. The position will report to the Director of Pharmacy . This position will play a key role in managing ... and Chest Pain Certification. Other accolades include CMS 5 stars Practice Green Health 2021 Leapfrog Hospital Safety Grade...hospital and upholding the ethics of the profession of pharmacy , the Manager Clinical Pharmacy facilitates the… more
- Martin's Point Health Care (Portland, ME)
- …as a "Great Place to Work" since 2015. Position Summary The Senior Director Clinical Programs provides oversight and coordination of care management and disease ... objectives, and analysis for the Martin's Point Health Plan. The Senior Director is responsible for Care Management design, implementation and operations and will… more
- CareOregon (Portland, OR)
- …Management activities. + Provide oversight of benefit determinations and appeals for medical and pharmacy as assigned by Senior Medical Director or CMO. + May ... Job Title Medical Director - Clinical Services Department Medical Management Administration...to improve population health, coordinate care, and meet CMS STARS measures. Job Summary This position is responsible for… more
- CVS Health (Columbus, OH)
- …are evidence-based. * Work collaboratively with the Behavioral Health, Pharmacy , member outreach, Care Management, National Quality Management, Utilization ... through peer review and educational interventions. * Work with medical director teams focusing on inpatient care management, clinical coverage review, member… more
- CVS Health (Austin, TX)
- …health care more personal, convenient and affordable. **Position Summary** As the Director of Commercialization and Growth, part of the Health Care Delivery business ... at least two or more of Providers, Health Plans, PBM and /or Pharmacy . + Experience in managing cross-functional teams in highly matrixed organizations, setting team… more
- VNS Health (Manhattan, NY)
- …all levels including but not limited to, Provider Relations, Claims, Medical Director , third party administrator, pharmacy benefit manager, to achieve resolution ... processes for continued improvement in staff knowledge, engagement with internal departments, STARS Measures, and enrichment of members experience with A&G. + Tracks… more
- Molina Healthcare (Florence, KY)
- …matrix, HEDIS work plans, and all product timelines. + Works with the Director to manage contacts within the plan(s) and/or Molina corporate, external auditors, ... Maximizes use of information from multiple sources, including claims/encounters, pharmacy , utilization management, clinical indicators, industry benchmark, and/or survey/vendor… more