- Elevance Health (Seven Fields, PA)
- **Business Information Analyst II - HEDIS Quality Analytics** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering ... and formats and utilizing multiple data systems to analyze HEDIS results is preferred. + Experience with relational databases...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… 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 the ... to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may...(RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
- US Tech Solutions (Canton, MA)
- …**2026** **Overview** + Under the general direction of the Quality Program Manager (s), the Medical Claims Research Specialist(s) will review medical claims reports ... record(s) and/or provider(s), and document follow-up actions during the HEDIS (Healthcare Effectiveness Data Information Set) reporting period. **Principal Duties… more
- Ventura County (Ventura, CA)
- …members to resolve service issues, ensure regulatory compliance (DMHC, NCQA, HEDIS ), and support wellness, prevention, and disease management programs. This position ... preventing diseases, and maintaining well-being; + Assumes responsibilities related to HEDIS , including data collection, reporting, and ensuring compliance with … more
- HCA Healthcare (Salt Lake City, UT)
- …integrity. We care like family! Jump-start your career as a(an) Manager Care Quality today with MountainStar Healthcare. **Benefits** MountainStar Healthcare, offers ... vary by location._** Come join our team as a(an) Manager Care Quality. We care for our community! Just...Home (PCMH), government programs (CMS), accountable care organizations (ACOs), HEDIS , and experience with payor cost sharing initiatives +… more
- Fallon Health (Worcester, MA)
- …on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The SUD Care Manager is responsible for ensuring seamless coordination of care for Fallon Health ... other partners-to promote integrated, member-centered care. The SUS Care Manager drives effective discharge planning, facilitates timely communication across care… more
- CenterWell (Houston, TX)
- …improvement best practice initiatives designed to improve Medicare quality measures ( HEDIS ), patient safety and patient experience (CAHPS-HOS). QIP assignment may be ... experience working with clinical quality measures in particular medication adherence and HEDIS . + Utilize approved avenues to outreach to patients with medication… more
- CVS Health (St. Louis Park, MN)
- …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 ... outcomes and program performance. + Collaborate with internal teams ( HEDIS , Clinical Operations, Network, Pharmacy, Product, Member Experience, Data/Analytics,… more
- Blue KC (MO)
- …discount program** **Job Description Summary:** The Integrated Health Advancement Program Manager leads an integrated behavioral health and health outcome strategy ... + Direct health outcome initiatives addressing systemic barriers to care, disparities in HEDIS and STAR measures, and drivers of social and behavioral health. +… more
- Health Care Service Corporation (Philadelphia, PA)
- …responsible managing daily activities and implementation of strategies for provider HEDIS and STARS performance, recruitment and contracting of physicians, physician ... of providers, and for ongoing provider service. As a manager , this individual will lead a team of Network...stays **Preferred Job Qualifications & Additional Details:** + Previous HEDIS and/or CMS STARs experience + Solid understanding of… more
- Centene Corporation (Atlanta, GA)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... experience at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost (MLR) and utilization. Pay Range: $56,200.00 - $101,000.00 per… more
- Centene Corporation (Tallahassee, FL)
- …performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Present detailed HBR analysis and ... health plan setting. Strong communication and presentation skills Proficient in HEDIS /Quality measures, cost and utilization. Pay Range: $70,100.00 - $126,200.00 per… more
- University of Southern California (Los Angeles, CA)
- In collaboration with the interdisciplinary team, the Case Manager provides care coordination services evaluating options and services required to meet an ... As more complex medical treatment options emerge the Case Manager will look to eliminate gaps in the care...+ Outcomes Management 1. Participates in core measure or HEDIS measure processes in identification of appropriate patients. 2.… more
- Sea Mar Community Health Centers (Puyallup, WA)
- …position(s): Sea Mar is a mandatory COVID-19 and flu vaccine organization Nurse Manager - Posting #26096 Nurse Manager RN Annual Salary: $85,470.00 Nurse ... LPN Annual Salary: $74,958.09 Position Summary: Full-time Nurse Manager position available for our Medical Clinic in Puyallup,...or hospitals + Focus clinic efforts on quality measures, HEDIS , and Meaningful Use standards + Provide annual MA… more
- Commonwealth Care Alliance (Boston, MA)
- …Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating strong, collaborative relationships with behavioral ... coordinated care for members. In this role, the Program Manager acts as an account manager , relationship...priorities. * Track provider progress on performance metrics (eg, HEDIS , readmissions, community tenure) and follow up to support… more
- Fallon Health (Lakeville, MA)
- **Overview** **The Nurse Case Manager is covering Lakeville, Acushnet, Fairhaven, Rochester and Mattapoisett and surrounding territory.** **About us:** Fallon Health ... and LinkedIn. **Brief summary of purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary...Program policies and processes Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member… more
- Sea Mar Community Health Centers (Aberdeen, WA)
- …following position(s): Sea Mar is a mandatory COVID-19 and flu vaccine organization Nurse Manager (RN or LPN) - Posting #27454 Hourly Rate: $36.04 - $44.44 Annual ... $74,958.09 - 92,444.35 (depending on license/experience) Position Summary: Full-time Nurse Manager position available for our Aberdeen Medical Clinic. Sea Mar… more
- Molina Healthcare (NY)
- JOB DESCRIPTION **Job Summary** The Care Manager provides support for care management/care coordination activities and collaborates with multidisciplinary team ... child welfare systems is strongly preferred. Skilled in closing HEDIS and preventive care gaps through proactive outreach and...resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and… more
- Elevance Health (Sacramento, CA)
- **Behavioral Health Community Partnership Manager ** **(Behavioral Health Provider Quality Manager )** **Sign on Bonus: $2,500** **Candidates must posses a ... insightful analytics to improve the delivery of care. The **Provider Quality Manager ** is responsible for leading Behavioral Health (BH) provider engagement, with a… more
- Sea Mar Community Health Centers (Tacoma, WA)
- …position: Sea Mar is a mandatory COVID-19 and flu vaccine organization Nurse Manager - Posting #25738 Salary Rate: $74,958.09 (LPN) - $92,444.35 (RN) Position ... Summary: Full-time Nurse Manager (RN or LPN) position available for our Tacoma...Focus clinic efforts on patient satisfaction, clinical quality measures, HEDIS , and Meaningful Use standards. + Provide annual MA… more