- Martin's Point Health Care (Portland, ME)
- …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Manager , HEDIS Program educates and serves as the HEDIS subject ... matter expert (SME). The Manager , HEDIS Program is responsible for coordinating, implementing, and executing HEDIS Program specific projects, and… more
- Medical Mutual of Ohio (OH)
- …by members, and members' health outcomes.** **Note: This is a fully remote opportunity. Eastern Time Zones preferred.** **Responsibilities** ** HEDIS Analyst II** ... more junior-level Analyst. May supervise staff in absence of Manager + Supports HEDIS submission lifecycle processes...keyboard, mouse and headset. + Whether you are working remote or in the office, employees have access to… more
- Centene Corporation (Harrisburg, PA)
- …of PA Health & Wellness, a subsidiary of Centene Corporation and will oversee program initiatives for the Medicaid product line of business encompassing HEDIS , ... strategic objectives. Collaborate with internal and external stakeholders to ensure HEDIS and CAHPS initiatives are fully integrated throughout the organization,… more
- Molina Healthcare (OH)
- …quality focused interventions and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including key ... manages, and/or compiles the required documentation to maintain critical program milestones, deadlines, and/or deliverables + Participates in quality improvement… more
- Molina Healthcare (Kearney, NE)
- **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success. * Partner with other teams to ensure data quality… more
- Sharp HealthCare (San Diego, CA)
- …Healthcare Quality (CPHQ) - National Association for Healthcare Quality; Certified Case Manager (CCM) - Commission for Case Manager Certification **Hours** **:** ... for the development and implementation of an effective Hospital Case Management program (HCM) and Ambulatory Case Management (ACM) program that encompasses… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …value based contracts and gap closure work. This Population Health Clinical Quality Manager will support the Medicare Shared Savings Program (MSSP) value-based ... care model. **Primary Function/General Purpose of Position** The Manager of Population Health Clinical Quality is responsible for...outreach, EHR reporting/tools, and data analysis. This is a remote /work at home position. Hire must be open to… more
- Sharp HealthCare (San Diego, CA)
- …for implementing the Utilization/Cost Management Program and Quality Improvement Program , in conjunction with the Manager Medical Management and Quality ... care needs of the membership. Serves as a medical manager and policy advisor to SHP and its Chief...plan Chief Medical Officer) in short and long range program planning, total quality management (quality improvement), and external… more
- Sharp HealthCare (San Diego, CA)
- …of care foundation for our NCQA required population health management program . Additionally, this position provides the representation of physician's insight, ... needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'...+ Plans, organizes, and directs the professional medical services program , consisting of all primary and specialty services for… more
- Molina Healthcare (Naperville, IL)
- …Improvement Compliance. + Acts as a lead specialist to provide project-, program -, and / or initiative-related direction and guidance for other specialists within ... with and between other departments within the organization. + Evaluates project/ program activities and results to identify opportunities for improvement. + Surfaces… more
- Centene Corporation (Frankfort, KY)
- …**Position Purpose:** Oversee and manage the functions of the quality improvement program , including HEDIS reporting and other quality improvement activities. ... competitive benefits including a fresh perspective on workplace flexibility. POSITION IS REMOTE PREFERABLY CST OR EST POTENTIAL TO WORK WEEKENDS DURING PEAK SEASON… more
- Centene Corporation (Carson City, NV)
- …to competitive benefits including a fresh perspective on workplace flexibility. **_ Remote role, desired candidate resides in Nevada, specifically in Elko County, ... in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Centene Corporation (Frankfort, KY)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
- Centene Corporation (Sacramento, CA)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Leveraging data, presents detailed HBR ... health plan setting. Strong communication and presentation skills Proficient in HEDIS /Quality measures, cost and utilization. Pay Range: $68,700.00 - $123,700.00 per… more
- Centene Corporation (Augusta, GA)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
- Humana (Springfield, IL)
- …and coaching associates. + Prior experience with healthcare quality measures STARS, HEDIS , etc. and/or clinical program monitoring/evaluation. + Knowledge of ... and behavioral health professionals responsible for care management. The Manager , Care Management, works within specific guidelines and procedures; applies… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for ... Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the… more
- Molina Healthcare (GA)
- **_ Remote and must live in Georgia _** **JOB DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for ... Plan. + Develops and implements strategies to increase provider engagement in HEDIS and quality initiatives. + Engages contracted network providers regarding cost… more
- Centene Corporation (Queens, NY)
- …differences between Risk and Value-Based contractual arrangements. + Responsible for understanding HEDIS and STARS measures and partners with Quality Team to drive ... plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay...additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that… more
- MedKoder (Mandeville, LA)
- …coders throughout the United States, MedKoder emphasizes coding excellence, remote -work flexibility, and a positive workplace culture, earning high employee ... Modern Healthcare and City Business Best Places to Work. Position Location: 100% Remote Position Classification: Full-time, 40 hour work week that offers a flexible… more