- Highmark Health (Buffalo, NY)
- …all the Organization's value-based programs for both the commercial and government business (ACA, Medicare STARS, Medicaid HEDIS , risk revenue). + Function ... 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… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …future health improvement efforts. * Support the (Health Effectiveness Data and Information Set) HEDIS Medical Records Review process, including performing chart ... Blue Cross and Blue Shield of Minnesota Position Title: Clinical Consultant Location: Hybrid | Eagan, Minnesota Career Area: Customer Service/Operations About… more
- Two95 International Inc. (New York, NY)
- Job Title: Sr. Analytics Consultant Job type : Remote Work Type : 6+ Months Contract with extension Rate : $Market /Hour Requirements Job Description: Primary ... the mutual goals and value based contracts, conduct assemble information and perform analyses to quantify baseline performance, identify...your job would be to: * Understand the client's business goals well-enough to ensure the SOW will meet… more
- Elevance Health (Richmond, VA)
- …for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery. **Build the Possibilities. ... Make an Extraordinary Impact.** **Title** : OB Practice Consultant **Virtual:** This role enables associates to work virtually full-time, with the exception of… more
- Elevance Health (Cincinnati, OH)
- **Wellness Nurse Consultant ** **Sign on Bonus: $5000** **Field:** This field-based role enables associates to primarily operate in the field, traveling to client ... will drive the future of health care. The **Wellness Nurse Consultant ** position is responsible for developing and recommending customized, group-specific strategies… more
- Elevance Health (Grand Prairie, TX)
- …in evaluating and analyzing complex initiatives strongly preferred + Government Business Experience strongly preferred + HEDIS /STARS experience preferred + ... the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our… more
- LA Care Health Plan (Los Angeles, CA)
- …This person needs to quickly gain working knowledge of LA Care Domain Business Practices and Information Technology Solutions, including the identification of ... how each System (Commercial or Custom) capability meets the Processing and Information requirements to implement business functions effectively * Be aware… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …management, and medical policy processes, and support for our various lines of business . The incumbent also provides input into the development of policies, programs ... in person meetings. + Serves as a resource and consultant to other areas of the company. + May...timely distribution and education related to departmental and Ethics/Compliance information . + Regular and reliable attendance is expected and… more
- Guidehouse (Mclean, VA)
- …**What You Will Do** **:** We are seeking a highly skilled and motivated Senior Consultant to join our Health Data Science team. This role will focus on claims ... as ICD-10, DRG, CPT, claims, encounters, risk scoring, and HEDIS measures + Minimum THREE (3) years experience in...Would Be Nice To Have** **:** + Experience with business intelligence tools for data visualizations such as Power… more
- CenterWell (Arlington, TX)
- …responsibilities as needed and demands a unique blend of clinical management, financial/ business acumen, and strategic partnership to optimize patient care and ... business outcomes. Job Description **KEY RESPONSIBILITIES** **Leadership & Organizational...Net Promoter Score (NPS) and Medicare clinical quality via HEDIS , meeting local and organizational goals + Personally deliver… more
- CenterWell (Seneca, SC)
- …directed by the Market CMO + Maintaining confidentiality of all patient information according to both state and federalguidelines and regulations + Maintaining ... Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice...to appropriately share and use your knowledge to improve business results. + Problem Solving: You are a problem… more
- CenterWell (Phoenix, AZ)
- …environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation ... to appropriately share and use your knowledge to improve business results. + Problem Solving: You are a problem...collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving… more
- Insight Global (Newtown, PA)
- …organization. You will leverage your understanding of healthcare data standards (ie HEDIS , FHIR, CMS interoperability, etc.) and Azure Data Platform (Databricks, ADF ... across multiple projects. * Establish data quality SLAs, metrics, and dashboards for business -critical datasets. * Ensure data QA practices adhere to HIPAA, CMS, and… more
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