- 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
- The Cigna Group (Bloomfield, CT)
- …and clinical metrics data collection, and design plans for enhanced provider engagement in quality initiatives + Perform financial analysis & participate ... Pima County based - Medicare Provider Performance Enablement (PPE) Senior...provider demographic records by validating and submitting all data management requests for completion. + Prepare for and… more
- BlueCross BlueShield of Tennessee (Knoxville, 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 (Bloomfield, CT)
- …a member of the clinical senior leadership team, the Chief of Staff for the Medicare Clinical Strategy team will report directly to the Vice President (VP) and Chief ... Medical Officer for Cigna Medicare (CMO), and will be responsible for supporting the...will assist in the management process for the Clinical Quality , Strategy and Solutions leadership team, including facilitating leadership… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …advanced statistical methodology including conjoint, max diff, regression analysis to provide data -driven conclusions. + Collaborates with other team members ... of the Medicare Advantage. This role supports Medicare product management by evaluating data trend...trusted by businesses and nonprofit organizations throughout Ohio to provide high- quality health, life, disability, dental, vision… more
- The Cigna Group (Denver, CO)
- …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
- USAA (San Antonio, TX)
- …working negotiated Medicare Exhausted claims, and other categories of Medicare claim settlements + Experience working with quality assurance program/process ... currently seeking a talented **Business Process Owner I** that will support Medicare Supplement Claims for USAA Life Company Claims Operations. This employee will… more
- The Cigna Group (Bloomfield, CT)
- …a Band 3 Management Career Track Role. **Customer Service Senior Supervisor- Medicare ** The Government Business CTM (Complaint Tracking Module) Complaint Resolutions ... Senior Supervisor is a leadership role within the Cigna Medicare Customer & Client Service Experience (CCSE) Organization reporting to the manager of CTMs. This role… more
- Medical Mutual of Ohio (OH)
- …all attempts in tracking software. . Collaborates with Clinical Intervention Pharmacists on Medicare Stars and other quality initiatives, with a strong focus on ... all attempts in tracking software. . Collaborates with Clinical Intervention Pharmacists on Medicare Stars and other quality initiatives, with a strong focus on… more
- Elevance Health (Smithfield, RI)
- **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 (Columbus, OH)
- …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
- Medical Mutual of Ohio (Brooklyn, OH)
- …we are trusted by businesses and nonprofit organizations throughout Ohio to provide high- quality health, life, disability, dental, vision and indemnity plans. ... mind to more than 1.6 million Ohioans through our high- quality health, life, disability, dental, vision and indemnity plans....stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide… more
- LA Care Health Plan (Los Angeles, CA)
- …at the right place at the right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income ... sessions/JAD sessions. Manage cross-functional partnerships with stakeholders responsible for quality measures and policy initiatives. Reviews data to… more
- LA Care Health Plan (Los Angeles, CA)
- …at the right place at the right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income ... Advantage, with experience serving duals population. Direct experience in Medicare and Duals program administration including stars, quality , financial… more
- Molina Healthcare (Long Beach, CA)
- …(QIA) in collaboration with the clinical lead, the medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA ... action plan, which includes strategies that ensure a high quality of patient care, ensuring that patients receive the...implementation and evidence-based medical practice. + Utilizes IT and data analysts to produce tools to report, monitor and… 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 (Houston, TX)
- …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 (Atlanta, GA)
- …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
- Fallon Health (Worcester, MA)
- …improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and ... Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high- quality , coordinated care and is continually rated among the nation's top… more