- UCLA Health (Los Angeles, CA)
- …Senior Project Manager to lead critical healthcare quality initiatives, including CMS Star Ratings and HEDIS (Healthcare Effectiveness Data and Information ... member outcomes, and regulatory readiness. Key Responsibilities: + Lead end-to-end execution of CMS Star Ratings and HEDIS initiatives and manage the entire… more
- Blue KC (MO)
- …discount program ** **Job Description Summary:** The Integrated Health Advancement Program Manager leads an integrated behavioral health and health outcome ... + 5+ years of experience in integrated care, managed care, or population health program management . + 3+ years of supervisory or leadership experience with… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Medical Policies, NCQA standards, HEDIS , CMS requirements, NYSDOH medical management mandates & program requirements and/or Blue Cross Blue Shield (BCBS) ... and accrediting entities including NYS DOH (OMH, OASAS, OCFS), CMS , NCQA and BlueCross BlueShield Association (BCBSA) for the...for the Federal Employee Program (FEP). The Manager serves as a resource to management ,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for ... Society of America (CMSA) Standards, NCQA Standards, Case Management Program activities, and performs the activities...regulatory requirements are being met, such as NYS DOH, CMS , NCQA, and HEDIS , serving as internal… more
- CDPHP (Latham, NY)
- …values and invites you to be a part of that experience. Conducts case management program activities in accordance with departmental, corporate, NYS Department of ... Society of America (CMSA) Standards, NCQA Standards, Case Management Program activities, and performs the activities...regulatory requirements are being met, such as NYS DOH, CMS , NCQA, and HEDIS , serving as internal… more
- Health Care Service Corporation (Philadelphia, PA)
- …including overnight stays **Preferred Job Qualifications & Additional Details:** + Previous HEDIS and/or CMS STARs experience + Solid understanding of health ... responsible managing daily activities and implementation of strategies for provider HEDIS and STARS performance, recruitment and contracting of physicians, physician… more
- University of Southern California (Alhambra, CA)
- …of case management . Some of the major duties of a Case Manager include: Documenting patients' case management plans and on-going activities; Identifying ... In collaboration with the interdisciplinary team, the Case Manager provides care coordination services evaluating options and...requested by department director or Medical Director. + Outcomes Management 1. Participates in core measure or HEDIS… more
- Commonwealth Care Alliance (Boston, MA)
- …Required Knowledge, Skills & Abilities (must have): * Proven experience in program management and performance monitoring initiatives or relevant position * ... Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the performance...Working knowledge of project/ program management practices * Ability to deal… more
- Banner Health (AZ)
- …of performance measures, methodology and processes. 7. In collaboration with Director, Manager , Supervisor of Quality Management and Information Systems, creates ... Committee for Quality Assurance (NCQA), Health Plan Employer Data Information Set ( HEDIS ), Arizona Health Cost Containment System (AHCCCS) and Centers for… more
- CenterWell (Orlando, FL)
- …Improvement, Clinical Professional 2 responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program . ... of provider relationships across the following areas: + Quality/clinical management and population health + HEDIS and...and RN experience **Preferred Qualification** + Strong knowledge of HEDIS /Stars/ CMS + Bachelor's Degree in Nursing +… more
- CenterWell (North Charleston, SC)
- …The Quality RN Professional responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program . The ... represents the scope of provider relationships across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance +… more
- CenterWell (Hampton, VA)
- …Improvement, Clinical Professional 2 responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program . ... represents the scope of provider relationships across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance +… more
- ChenMed (Berwyn, IL)
- …and care teams to optimize medication use, improve patient outcomes, and enhance CMS Star Ratings and HEDIS quality measures. This position requires advanced ... Certified to provide immunization is a plus + Completion of Medication Therapy Management certificate program or Ambulatory Care Certificate a plus **PAY… more
- MedKoder (Mandeville, LA)
- About Us MedKoder, LLC is a full-service medical coding management services provider based in Mandeville, Louisiana, specializing in expert medical coding for health ... accurately coding all professional multi-specialty services including evaluation and management , diagnostics, surgeries, and procedures in compliance with applicable… more