- CVS Health (Hartford, CT)
- …improvement, engagement campaigns, and program development with the goal of improving Medicare Star Ratings . Responsibilities include developing and managing ... value to Medicare Advantage beneficiaries. Optimizing business performance and Star Ratings is a foundational element of our mission.Required Qualifications… more
- The Cigna Group (Philadelphia, PA)
- …Evernorth Health Services departments to achieve company goals for increasing Cigna's Star ratings . **Primary Responsibilities include, but are not limited to:** ... role is responsible for developing and executing enterprise strategies to improve Cigna's Medicare Part D Star measures and related quality measures. This… more
- St. Luke's University Health Network (Bethlehem, PA)
- …Children's Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare 's five- star ratings (the highest) for quality, efficiency and ... and procedural scheduling specialist is responsible for scheduling appointments for Star Wellness patients. He/She will perform all functions related to insurance… more
- The Cigna Group (Baltimore, MD)
- …that drive customer engagement with the plan leading to better health outcomes, STAR ratings , and benefit utilization. + Development of annual customer ... and benefit utilization. + Leading email communication strategy & process and communication plan for all Medicare ...& process and communication plan for all Medicare Advantage customers. Strategy includes ideas on how to… more
- St. Luke's University Health Network (Bethlehem, PA)
- …Children's Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare 's five- star ratings (the highest) for quality, efficiency and ... and accurately enter charge information, assist physician with accurate coding information and process in a timely fashion to the Central Business Office. + Be… more
- St. Luke's University Health Network (Allentown, PA)
- …Children's Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare 's five- star ratings (the highest) for quality, efficiency and ... sign-up at check-in + Ensure all information is correct during insurance verification process (RTE) + Verify all patient consents are current (ie: HIPPA, Financial… more
- LA Care Health Plan (Los Angeles, CA)
- …implementing, and guiding projects relating to quality excellence in Centers for Medicare and Medicaid Services (CMS) Five- Star Rating System and Marketplace ... to request an exemption, LA Care has implemented a process to consider exemptions, for documented medical conditions and...short and long term operational goals to improve Stars ratings . The SPM will track, manage, and report project… more
- Universal Health Services (Reno, NV)
- …state Medicaid offices (as relevant), and NCQA. + Developing opportunities to drive Star ratings performance and ensure a positive member experience. Benefit ... 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage, Accountable Care Organizations, and commercial payer… more
- Marshfield Clinic (Marshfield, WI)
- …improve Healthcare Effectiveness Data and Information Set (HEDIS) standards and five star ratings . 5. Assists leadership with developing and implementing metrics ... Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS), and 5 Star Quality Measures. Position can be remote or in office. **JOB QUALIFICATIONS**… more
- St. Luke's University Health Network (Allentown, PA)
- …Children's Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare 's five- star ratings (the highest) for quality, efficiency and ... regardless of a patient's ability to pay for health care. The Robotics Process Automation Builder creates RPA bots designed to automate processes and provide… more
- Nuvance Health (Poughkeepsie, NY)
- …the Center for Medicare & Medicaid Services Value Based Purchasing and Star Ratings programs, Leapfrog Patient Safety program, commercial pay for performance ... improve processes, and provide follow-up & monitoring to evaluate progress and ensure process changes are hardwired. 4.Manages and organizes the work of the Quality… more
- Cleveland Clinic (Cleveland, OH)
- …Medicaid, and Medicare Advantage quality measures, NCQA and HEDIS standards, and Medicare Advantage star ratings gained through experience preferred. + ... of value based contract related work experience + Experience with Medicaid and Medicare + Experience working in a health system, hospital, medical practice, or payor… more
- St. Luke's University Health Network (Stroudsburg, PA)
- …Children's Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare 's five- star ratings (the highest) for quality, efficiency and ... Access Representative I is responsible for the entire scope of the registration process for patients seen at St. Luke's University Health Network, in outpatient… more
- St. Luke's University Health Network (Allentown, PA)
- …Children's Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare 's five- star ratings (the highest) for quality, efficiency and ... interventions/activities and to provide direct care to patients of Star Community Health as part of Dental Service Encounters...c ip ates in Qu a li ty Improvement process PH YSICA L AN DS EN SORYREQ UIR… more
- St. Luke's University Health Network (Quakertown, PA)
- …Children's Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare 's five- star ratings (the highest) for quality, efficiency and ... applicable state/federal regulatory notices as applicable ie.) Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON), Bundle… more
- The Cigna Group (Westerville, OH)
- …operations, CMS Risk Adjustment and HCC coding process and quality including Medicare Star Ratings and HEDIS + Strongly preferred experience with ... This role is responsible for supporting Cigna Medicare Advantage risk adjustment prospective programs, solutions, and...teams and provider group to ensure effective and compliant process in place to address gaps in care for… more
- St. Luke's University Health Network (Bethlehem, PA)
- …Children's Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare 's five- star ratings (the highest) for quality, efficiency and ... AND RESPONSIBILITIES: + Provides full range of dental care services to Star Community Health dental patients. + Demonstrates competency in the assessment, range… more
- St. Luke's University Health Network (Allentown, PA)
- …Children's Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare 's five- star ratings (the highest) for quality, efficiency and ... education training/seminars and reading related periodicals. + Familiar with process improvement and project management methodologies. + Participates in… more
- St. Luke's University Health Network (Allentown, PA)
- …Children's Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare 's five- star ratings (the highest) for quality, efficiency and ... + Meet with all patients at or before first appointment to review Star Community Health Sliding Fee Discount Program and determine financial needs + Meet… more
- St. Luke's University Health Network (Bethlehem, PA)
- …Children's Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare 's five- star ratings (the highest) for quality, efficiency and ... vendor to obtain wound care equipment for discharge. + Responds to Medicare appeal inquiries for processing. + Maintains concurrent communication with care managers… more