• HEDIS Reviewer

    Centers Plan for Healthy Living (Garden City, NY)
    HEDIS Reviewer 990 Stewart Ave, Garden City, NY 11530, USA Req #879 Monday, April 29, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... guidance and plans they need for healthy living. JOB SUMMARY: The HEDIS Reviewer is responsible for supporting the overall direction, coordination and implementation… more
    Centers Plan for Healthy Living (04/30/24)
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  • HEDIS Coordinator

    Somatus (Mclean, VA)
    …and mental well-being + Community engagement opportunities + And more! The HEDIS Coordinator will perform the functions related to the outreach, collection, and ... entering of medical records and service data according to HEDIS / Somatus Technical Specifications. The primary focus of...Responsibilities + Coordinate, complete, and update management on all HEDIS processes and results. + Work with providers and… more
    Somatus (05/14/24)
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  • Behavioral Health HEDIS Quality Program…

    Elevance Health (Columbus, GA)
    …and insightful analytics to improve the delivery of care. **Behavioral Health HEDIS Quality Program Director** This is an Individual Contributor Role. Location: ... Hours: **Monday through Friday, 40 hrs a week.** The **Behavioral Health HEDIS Quality Program Director** is responsible for leading and implementing enterprise-wide… more
    Elevance Health (05/10/24)
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  • HEDIS Analytics Developer Consultant

    Elevance Health (Columbus, OH)
    ** HEDIS Analytics Developer Consultant** **Location:** This position will work in a hybrid model (remote and office). The Ideal candidate will live within 50 miles ... of one of our Elevance Health PulsePoint locations. The ** HEDIS Analytics Developer Consultant** will be responsible for developing and executing more complex data… more
    Elevance Health (05/17/24)
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  • HEDIS Specialist

    Centene Corporation (Tallahassee, FL)
    …Purpose:** Supervise and facilitate successful interventions to meet behavioral health HEDIS and Pay for Performance measures. Partner with health plans and ... regional clinical leadership to identify and implement interventions to increase HEDIS rates in behavioral health measures. + Develop and implement innovative… more
    Centene Corporation (05/26/24)
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  • HEDIS Business Information Consultant

    Elevance Health (Cincinnati, OH)
    ** HEDIS Business Information Consultant** **Location:** This position will work in a hybrid model (remote and office). The Ideal candidate will live within 50 miles ... of one of our Elevance Health PulsePoint locations. The ** HEDIS Business Information Consultant** is responsible for serving as...and customers. This position is part of the Enterprise HEDIS Implementation Team. It will be responsible for working… more
    Elevance Health (05/08/24)
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  • Behavioral Health HEDIS Quality Program…

    Elevance Health (New York, NY)
    …as needed **Shift:** Monday - Friday; 8:00am - 5:00pm ET The **Behavioral Health HEDIS Quality Program Manager** is responsible for serving as the quality lead and ... you will make an impact:** + Leads plan level HEDIS strategy to drive improvement in behavioral health ...HEDIS strategy to drive improvement in behavioral health HEDIS measures, ensuring achievement in performance guarantees and/or service… more
    Elevance Health (05/21/24)
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  • Sr. Specialist, Provider Engagement- Quality…

    Molina Healthcare (AZ)
    …to one or more of these quality improvement functions: * Will create actionable HEDIS data and analytic insights. * Acts as a lead specialist to provide project-, ... (CPHQ) * Nursing License (RN may be preferred for specific roles) * Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested… more
    Molina Healthcare (05/04/24)
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  • HEDIS Application Administrator Senior

    Geisinger (Danville, PA)
    …and testing of applicable technology. + 5+ years of experience in running a HEDIS engine. + 5+ years of experience in analyzing HEDIS measure results ... at the data level, investigating compliance/non-compliance reasons + 5+ years of experience in supporting regulatory quality reporting. Work is typically performed in an office or remote environment. Accountable for satisfying all job specific obligations and… more
    Geisinger (05/02/24)
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  • Business Analyst IV ( HEDIS )

    Centene Corporation (Springfield, IL)
    …process or data analysis preferably in healthcare or 5+ years of HEDIS analysis. Advanced knowledge of Microsoft Applications, including Excel and Access preferred. ... Project management experience preferred. Pay Range: $84,300.00 - $151,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus… more
    Centene Corporation (04/26/24)
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  • Associate Quality Practice Advisor

    Centene Corporation (St. Louis, MO)
    …sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record ... deficiencies impacting plan compliance to meet State and Federal standards for HEDIS . + Under general guidance form Senior Quality Practice Advisors and management,… more
    Centene Corporation (05/26/24)
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  • Quality Practice Advisor

    Centene Corporation (Tallahassee, FL)
    …provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, ... plan compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for...as a resource for the health plan peers on HEDIS measures, appropriate medical record documentation and appropriate coding.… more
    Centene Corporation (05/26/24)
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  • Quality Improvement Project Manager

    Centene Corporation (Tallahassee, FL)
    …Quality Assurance (NCQA) and Healthcare Effectiveness Data and Information Set ( HEDIS ) preparation. + Provide functional and technical knowledge for NCQA/ HEDIS ... constituents as needed. + Coordinate Work Plan, team and resources for HEDIS /Consumer Assessment of Healthcare Providers and Systems (CAHPS) submission to Connector… more
    Centene Corporation (05/26/24)
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  • Medicare Advantage Quality Consultant

    Highmark Health (Charleston, WV)
    …is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office based support to ... PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value creation, cost control… more
    Highmark Health (05/10/24)
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  • Staff VP, Carelon Health STARS

    Elevance Health (Cerritos, CA)
    …our organization, you'll have the chance to spearhead quality-enhancement campaigns ( HEDIS ) and launch initiatives that support STARS improvement. Your expertise and ... not limited to:** + Drives provider performance improvement for HEDIS , STARS, State Contract Quality & Pay for Performance/Withhold...+ Assume a key role in Quality Management Scorecards, HEDIS , HOS and CAHPS operations. + Develop strategic … more
    Elevance Health (05/24/24)
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  • Lead Director Quality Management

    CVS Health (Overland Park, KS)
    …will be a critical leader in Service Excellence, serving as a HEDIS subject matter expert and responsible for driving strategic initiatives, managing operational ... Service Excellence organization. Serve as a subject matter expert on HEDIS processes, particularly with respect to reporting requirements, quality measures,… more
    CVS Health (05/12/24)
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  • Healthcare Data Architect (Remote)

    Martin's Point Health Care (Portland, ME)
    …building and maintaining robust data infrastructure for Health Plan Risk Adjustment, HEDIS , Quality, and Clinical to support strategic analytics and reporting used ... and operations related to risk score and revenue projections, CMS submissions, HEDIS data submissions, population health, etc. + Reviews database architectures and… more
    Martin's Point Health Care (04/16/24)
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  • Clinical Quality Project Coordinator

    Healthfirst (NY)
    Duties and Responsibilities: Support providers with HEDIS care gap closures through member outreach and appointment scheduling Educate members on the importance of ... Perform medical record reviews and data abstraction consistent with HEDIS measure technical specifications Provide detailed updates on regulatory audits,… more
    Healthfirst (05/24/24)
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  • Quality Improvement Abstractor

    Centene Corporation (Columbia, SC)
    …Lead data collection and abstraction for company quality measures, including HEDIS , CMS, CHIPRA and/or any other custom measurements. + Assess vendor-delegated ... abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards...standards + Review medical records and abstract data for HEDIS and other measure sets in compliance with standards… more
    Centene Corporation (05/23/24)
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  • Behavioral Health Clinical Qual Prog Manager

    Elevance Health (Cincinnati, OH)
    …responsible for developing, implementing, and monitoring Quality initiatives to improve HEDIS and execute quality strategic priorities across the organization in ... to execute on targeted interventions to improve behavioral health HEDIS and other quality outcomes. + Develops tools, resources,...designs for major line of business. + Serve as HEDIS SME to quality and other departments to provide… more
    Elevance Health (05/21/24)
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