- Humana (Little Rock, AR)
- …and Compliance, and Risk Adjustment, as well as vended partners. The Senior HEDIS Operations & Quality Professional supports all aspects of the ... technology implementation, and data management/reporting. The Senior HEDIS Operations & Quality Professional champions a collaborative environment… more
- UCLA Health (Los Angeles, CA)
- …seeking an experienced Senior Project Manager to lead critical healthcare quality initiatives, including CMS Star Ratings and HEDIS (Healthcare Effectiveness ... + Develop and manage project plans, timelines, and deliverables + Oversee HEDIS operations , including data submission, audits, and hybrid chart abstraction… more
- The Cigna Group (Bloomfield, CT)
- …partner teams such as Data Engineering, Interoperability, Clinical Initiatives, and HEDIS Operations **Qualifications:** + Master's degree preferred, or ... **Job Overview:** This role is responsible for driving the Clinical Quality data acquisition strategy and data product support within the Enterprise Quality &… more
- Centene Corporation (Lansing, MI)
- …State and Federal standards for HEDIS . + Under general guidance form Senior Quality Practice Advisors and management, educates community physician and small ... practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education...Provider Relations to improve provider performance in areas of Quality , Risk Adjustment and Operations (claims and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Senior Medical Record Retrieval Operations Specialist Location: Hybrid | Eagan, ... Minnesota Career Area: Customer Service/ Operations About Blue Cross and Blue Shield of Minnesota...position supports the team with primary accountabilities related to quality improvement, Medical Records Review (MRR), and provider outreach… more
- Insight Global (Virginia Beach, VA)
- …Case Management, Reporting Workbench, SlicerDicer (Preferred) * Familiarity with CMS quality programs, HEDIS measures, and risk adjustment (Preferred). * ... efficient system performance and integration with business and clinical operations . This role involves evaluating software releases, analyzing business...Familiarity with CMS quality programs, HEDIS measures, and risk adjustment.… more
- CenterWell (Phoenix, AZ)
- …relationship environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding ... space and equipment and center needs. + Oversee daily operations of physician services. + Build strong relationship with...and other providers to form a narrow network of quality service focused on senior population health… more
- CVS Health (Jackson, MS)
- …conduct robust impact and descriptive analyses, and collaborate closely with clinical, quality , and operations teams to identify emerging opportunities that ... outputs are interpretable and actionable. + Collaborate cross-functionally with Clinical Operations , Member Experience, and Quality teams to align analytics… more
- Insight Global (Chicago, IL)
- …conduct robust impact and descriptive analyses, and collaborate closely with clinical, quality , and operations teams to identify emerging opportunities that ... outputs are interpretable and actionable. * Collaborate cross-functionally with Clinical Operations , Member Experience, and Quality teams to align analytics… more
- Molina Healthcare (Milwaukee, WI)
- …* Knowledge of health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) * Knowledge of health ... JOB DESCRIPTION Job Summary Provides senior level analyst support for medical economics analysis...tools to monitor trend drivers and provides recommendations to senior leaders for affordability opportunities. * Leads projects to… more
- Humana (Louisville, KY)
- …health, SDOH, behavioral health, pharmacy strategy, care management strategy), and Quality (withhold management, HEDIS management, value-based payment strategy, ... to inform program design and measurement. ** Quality :** + Oversee quality management, including withhold management, HEDIS performance, Value-Based Payment… more
- Health Care Service Corporation (Chicago, IL)
- …initiatives that effectively target variations in healthcare measures. 5) Collaborate with Quality Operations team to coordinate quality improvement outreach ... consistent with HCSC goals, regulatory requirements, and accreditation. The senior director will remain current with best practices and...projects as required or requested. 9) Maintain currency with HEDIS , Hospital and other quality data sets,… more
- Centene Corporation (Jefferson City, MO)
- … Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set ( HEDIS ) performance + Responsible for quality improvement aspects of ... to improve overall STARS ratings for Medicare products (including HEDIS , CAHPS, HOS) + Oversee provider satisfaction surveys and...preferred + 7+ years of quality management, quality improvement or healthcare operations experience required… more
- UNC Health Care (Morrisville, NC)
- …services. The director collaborates with senior -level staff accountable for daily operations , finance, payer contracts, and quality measures, leading a team ... **Description** **Director of Ambulatory Quality and Population Health Analytics** Become part of...and internal customer service. This individual collaborates with UNCHA senior executives in setting strategy and developing business plans,… more
- Mount Sinai Health System (New York, NY)
- …point of contact for payer quality reporting * Content expertise for standard quality measures ( HEDIS , PQRS, MIPS, etc.) * Interface with analytics, IT, and ... largest non-profit health systems in the US with a strong reputation for quality of care (18th ranked academic medical center) and research/education (22nd ranked… more
- CenterWell (Jacksonville, FL)
- …environment + Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality indicators **Additional Information** + Guaranteed base salary + ... (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS , meeting local and organizational goals + Personally deliver… more
- CVS Health (Springfield, IL)
- …operational support including driving process improvements, ensuring compliance and quality assurance, conducting data analysis and reporting, participating in ... teams, and contributing to project management. Works to optimize clinical operations , enhance efficiency and compliance, and support the delivery of high-… more
- CenterWell (Daytona Beach, FL)
- …(KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS , meeting local and organizational goals *Personally deliver ... combining clinical practice with leadership and operational management to ensure high- quality patient care and alignment with Value-Based Care (VBC) principles. This… more
- CenterWell (Columbia, SC)
- …such as patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS , meeting local and organizational goals + Personally deliver ... combining clinical practice with leadership and operational management to ensure high- quality patient care and alignment with Value-Based Care (VBC) principles. This… more
- CenterWell (Hampton, VA)
- …(KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS , meeting local and organizational goals. + Personally ... combining clinical practice with leadership and operational management to ensure high- quality patient care and alignment with Value-Based Care (VBC) principles. This… more