- Molina Healthcare (OH)
- **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements new and existing clinical quality member intervention ... improvement of intervention processes and outcomes. Acts as a lead specialist within the department and/or collaboratively with other departments. Please include… more
- Molina Healthcare (NV)
- **Job Description** **Job Summary** The Senior Specialist , Quality Program Management and Performance implements new and existing healthcare quality improvement ... and monitoring for key quality program activities. Acts as a lead specialist to provide project, program, and/or initiative related direction. Provides guidance for… more
- Molina Healthcare (Rockford, IL)
- …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Interventions / QI Compliance contributes to one or ... Quality Interventions and Quality Improvement Compliance. + Acts as a lead specialist to provide project-, program-, and / or initiative-related direction and… more
- CareFirst (Baltimore, MD)
- …and contributes to thought leadership for quality measure capture (NCQA, HEDIS , STARs). Collaborates with internal stakeholders on process and outcome improvement ... data collection tools. **Licenses/Certifications Upon Hire Required:** + CCS-Certified Coding Specialist + Certified Coder (CCS or CPC)-AHIMA or AAPC Salary Range:… more
- Centene Corporation (Lansing, MI)
- …all clinical initiatives including, case and disease management, behavioral health and HEDIS outcome measures + Evaluate the analysis and responses on all quality ... Complies with all policies and standards **This position is remote with field-based responsibilities, requiring 25-50% travel to both...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Centene Corporation (Lansing, MI)
- …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
- Molina Healthcare (NY)
- …BH services/resources and community supports is highly preferred. Skilled in closing HEDIS and preventive care gaps through proactive outreach and coordination with ... and health equity principles. Case management and managed care experience is highly preferred. Remote position based in New York A New York LCSW or LMHC licensure is… more
- Beth Israel Lahey Health (Winchester, MA)
- …independent private practice and builds collaborative relationships with Highland's Specialist Practices and/or Highland's Primary Care practices to achieve results ... risk performance/management operations a plus + Knowledge of and experience with HEDIS quality metrics, risk coding, electronic medical records such as Epic, Athena,… more
- Beth Israel Lahey Health (Wakefield, MA)
- …health, well-being, and preventative healthcare. This role is primarily virtual/ remote , with occasional opportunities for in-person work depending on program ... blood pressure, diabetes, and cancer screenings. 2. Learn about HEDIS ambulatory quality measures and uses that knowledge to...3. In close partnership with the BILHPN Population Health Specialist , acts as a key resource to practice(s) for… more
- Beth Israel Lahey Health (Winchester, MA)
- …builds collaborative relationships with Highland's Primary Care Practices and/or Highland's Specialist practices to achieve results that are consistent with the ... two (2) years leading complex projects + Knowledge of and experience with HEDIS quality metrics, electronic medical records such as Epic, Athena, and eCW preferred… more
- CenterWell (Phoenix, AZ)
- …+ Oversee daily operations of physician services. + Build strong relationship with specialist , hospitalist, SNF and other providers to form a narrow network of ... Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice...Off/Holidays + Minimal call Travel: While this is a remote position, occasional travel to Humana's offices for training… more