- CVS Health (Trenton, NJ)
- …and MLOps practices + Apply advanced modeling and statistical analysis to Healthcare Quality metrics spanning NCQA HEDIS measures and CMS Clinical Stars + ... Apply advanced statistical, machine learning, and deep learning methods (eg, ARIMA, Prophet, gradient boosting,) + Performs code reviews and enforces coding standards, based on company and industry requirements, across the development teams. + Identifies and… more
- UCLA Health (Los Angeles, CA)
- Description UCLA Health is seeking an experienced Senior Project Manager to lead critical healthcare quality initiatives, including CMS Star Ratings and ... This role is key to ensuring successful execution of enterprise-wide quality programs and supporting improvements in performance metrics, member outcomes, and… more
- Molina Healthcare (OH)
- …within the department and/or collaboratively with other departments. Please include any HEDIS / Quality experience on your resume. This experience is important for ... & Community Interventions oversees and implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare,… more
- The Cigna Group (Bloomfield, CT)
- …population health outcomes through data-driven clinical initiatives. The Business Analytics Senior Manager is responsible for managing complex projects, ... continuous improvement perspective to identify data automation opportunities, improve data quality /accuracy, and curate actionable insights. The Sr. Manager must… more
- The Cigna Group (Bloomfield, CT)
- **Job Overview:** This role is responsible for driving the Clinical Quality data acquisition strategy and data product support within the Enterprise Quality & ... data being acquired will be used to measure clinical quality results that ultimately allow Cigna to benchmark against...improvements in patient outcomes. This data will feed into HEDIS (healthcare effectiveness data and information set) and NCQA… more
- Providence (Tarzana, CA)
- **Description** Senior Manager Quality Improvement...of leadership experience + 8 years of experience in Quality Improvement and HEDIS measures + 2 ... between Quality Improvement, core leaders, caregivers, and system teams. The Senior Manager position provides specialized guidance and tools to train,… more
- Ventura County (Ventura, CA)
- …two (2) years of full-time experience in Case Management, Disease Management, Quality Assurance, HEDIS and/or Utilization Review. NECESSARY SPECIAL REQUIREMENTS ... Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5113983)...workforce in the Ventura County Health Care Plan's (VCHCP) Quality Management Department! VCHCP is a County sponsored Health… more
- Fallon Health (Boston, MA)
- …Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high- quality , coordinated care and is continually rated among the nation's top ... health plans for member experience, service, and clinical quality . We believe our individual differences, life experiences, knowledge, self-expression, and unique… more
- Molina Healthcare (NV)
- **Job Description** **Job Summary** The Senior Specialist, Quality Program Management and Performance implements new and existing healthcare quality ... the Manager and/or Director to maintain up-to-date addendums to quality policies and procedures that clearly document state-specific activities and requirements… more
- Molina Healthcare (Rockford, IL)
- …accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Interventions / QI Compliance ... **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans, and implements new...results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may… more
- ERP International (Camp Pendleton, CA)
- …communication strategies. * Collaborate with the Healthcare Effectiveness Data and Information Set ( HEDIS ) Clinical Quality Teams on a monthly basis to evaluate ... a current AHA OR ARC BLS Healthcare Provider certification. **Specific Quals for Program Manager / Senior Strategist** * Knowledge of the military health system.… more
- LA Care Health Plan (Los Angeles, CA)
- …purpose. Job Summary The Technical Application Manager II reports to the Senior Manager Information Technology IT Solutions Delivery. This role acts as the ... Technical Applications Manager II Job Category: Information Technology Department: IT...Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and… more
- CenterWell (Phoenix, AZ)
- …relationship environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding ... and other providers to form a narrow network of quality service focused on senior population health...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- CenterWell (Lake Park, FL)
- …represents the scope of provider relationships across the following areas: + Quality /clinical management and population health + HEDIS and Stars performance ... unless otherwise specified + Proven work experience as a HEDIS Nurse or similar role in healthcare quality...insurance and many other opportunities. **About Us** About Conviva Senior Primary Care: Conviva Senior Primary Care… more
- CenterWell (North Charleston, SC)
- …represents the scope of provider relationships across the following areas: + Quality /clinical management and population health + HEDIS and Stars performance ... clinical nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare quality...insurance and many other opportunities. **About Us** About CenterWell Senior Primary Care: CenterWell Senior Primary Care… more
- Beth Israel Lahey Health (Winchester, MA)
- …to the Associate Director of Quality and Performance Improvement, the Senior Project Manager , Performance Improvement furthers the mission of Highland ... performance/management operations a plus + Knowledge of and experience with HEDIS quality metrics, risk coding, electronic medical records such as Epic, Athena,… more
- CenterWell (New Smyrna Beach, FL)
- …(RN) represents the scope of provider relationships across the following areas: + Quality /clinical management and population health + HEDIS and Stars performance ... clinical nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare quality...insurance and many other opportunities. **About Us** About Conviva Senior Primary Care: Conviva Senior Primary Care… more
- CVS Health (St. Louis Park, MN)
- …we do it all with heart, each and every day. **Position Summary** As the ** Senior Manager of Stars** , you will lead the market-wide strategy, performance ... improvement, and execution of the Medicare Stars quality program for Allina Health | Aetna Medicare membership in Minnesota. Your goal is to achieve and sustain high… more
- CenterWell (Jacksonville, FL)
- …with clinicians to achieve optimal patient outcomes and company initiatives, including Quality , HEDIS /STARs, AHCA, financial management, and employee and patient ... healthcare professional who leads the daily operations of our senior primary care centers and upholds our model of...performing audits of clinical logs to ensure compliance and quality , manage MSDS and OSHA concerns, and address clinic… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …BlueCross BlueShield Association (BCBSA) for the Federal Employee Program (FEP). The Manager serves as a resource to management, internal staff, regulatory and ... implemented consistently per department policies, procedures and guidelines. Facilitates quality , cost effective medical and benefits management and monitors results… more