- Elevance Health (Columbus, GA)
- …for autism and depression, and insightful analytics to improve the delivery of care. ** Behavioral Health HEDIS Quality Program Director** This is ... office.** Work Shift Hours: **Monday through Friday, 40 hrs a week.** The ** Behavioral Health HEDIS Quality Program Director** is responsible for leading… more
- Elevance Health (New York, NY)
- …Plaza New York, NY as needed **Shift:** Monday - Friday; 8:00am - 5:00pm ET The ** Behavioral Health HEDIS Quality Program Manager** is responsible for ... as the quality lead and overseeing the quality improvement activities/projects/programs for one or more health...level HEDIS strategy to drive improvement in behavioral health HEDIS measures, ensuring… more
- Elevance Health (Cincinnati, OH)
- …analytics, operations teams to execute on targeted interventions to improve behavioral health HEDIS and other quality outcomes. + Develops tools, ... and insightful analytics to improve the delivery of care. ** Behavioral Health Clinical Quality Program...operations across functional areas strongly preferred. + **Experience with behavioral health HEDIS and specifically… more
- Centene Corporation (Tallahassee, FL)
- …reside in Florida **Position Purpose:** Supervise and facilitate successful interventions to meet behavioral health HEDIS and Pay for Performance measures. ... collaboration with clinical staff to improve compliance with key behavioral health HEDIS metrics and...funding or resources + Act as a liasion with quality improvement, health plan medical management and… more
- Elevance Health (Louisville, KY)
- … health or related field and a minimum of 3 years experience in quality improvement and/or behavioral health , risk management and/or utilization review in ... the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health ...annual and ad hoc medical record reviews such as HEDIS and CPG compliance. + Conducts quality … more
- Elevance Health (Hanover, MD)
- …Responsible for all KPIs in the contract related to Quality . + Leads Health Employer Data Information Sets ( HEDIS ) reporting and the development of action ... the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health ...experience in a Managed Care Organization preferred. + Population health management and/or clinical quality program development… more
- Centene Corporation (Baton Rouge, LA)
- …(NCQA) and State standards and regulations including timelines + Investigate and resolve behavioral health quality of care complaints and grievances ... and licensure. Must have at least 3 years of behavioral health clinical experience. Quality /auditing...HEDIS ) measures and program evaluation (trilogy documents) for behavioral health + Lead Behavioral … more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Manager supports the Director of Behavioral Health Services and the CareFirst Mission of providing affordable ... effective, efficient workforce to support all aspects of the Behavioral Health Services department across the continuum...+ Knowledge of managed care principles and concepts including Health Plan Employer Data and Information Sheet ( HEDIS… more
- Molina Healthcare (Albuquerque, NM)
- **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management and ... quality programs for mental health and chemical...and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. ** Based… more
- Centene Corporation (Tallahassee, FL)
- …goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members' current functional level and, in ... assigned. + Complies with all policies and standards. **Education/Experience:** Master's degree in behavioral health and an unrestricted license as a LCSW, LMFT… more
- Centene Corporation (Topeka, KS)
- …goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members' current functional level and, in ... assigned + Complies with all policies and standards **Education/Experience:** Master's degree in behavioral health and an unrestricted license as a LCSW, LMFT or… more
- Centene Corporation (Springfield, IL)
- …goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members' current functional level and, in ... Home & Community Based waivers 1 x 90 days). **Education/Experience:** Master's degree in behavioral health and an unrestricted license as a LCSW, LMFT or LPC,… more
- Centene Corporation (Springfield, IL)
- …goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members' current functional level and, in ... for 10% travel into office for mandatory meetings. **Education/Experience:** Master's degree in behavioral health and an unrestricted license as a LCSW, LMFT or… more
- Highmark Health (Charleston, WV)
- …and outcomes strategic plan development + Experience with Medicare STARS, Medicaid HEDIS , risk revenue value streams, and population health management ... skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on,...Experience in Lean, Six Sigma, TQI, TQC or other quality management certification + Experience in health … more
- Baystate Health (Springfield, MA)
- …and physician practice sites, and across key partners such as post-acute, community, Behavioral health and LTSS partners. This is accomplished through network ... of managed care plans and PHOs (Baycare), the skilled nursing facility network, home health network, behavioral health and other community partners.. +… more
- Highmark Health (Dover, DE)
- …years of combined experience with RN/LPN, Risk Adjustment HCC Coding, medical coding/billing, HEDIS , and/or health related field in lieu of bachelor's degree ... and implements process improvements related to the potential of quality medical care and service to members and to...experience with RN/LPN, Risk Adjustment HCC Coding, medical coding/billing, HEDIS , and/or health related field **LICENSES AND… more
- CVS Health (Austin, TX)
- …and implement Quality Improvement Initiatives (QIAs) aligned to priority behavioral and mental health performance measures and member satisfaction. Develop ... Bring your heart to CVS Health . Every one of us at CVS ...(providers, specialists).Required Qualifications + 3-5 years managed care and/or quality improvement experience + 3-5 years project management experience… more
- Centene Corporation (St. Louis, MO)
- …Work or related field. required:** 5+ years managed care experience related to HEDIS OR GPRO record review, quality improvement, medical coding or, transferable ... eligibles experience. preferred **2+ years Designing, developing and implementing STARS, CAHPS, HEDIS and other enterprise quality related programs across a… more
- CVS Health (Springfield, IL)
- … Management includes, but is not limited to, QM Programs/Infrastructure, behavioral health QM, credentialing, delegation and regulatory accreditation support, ... experience and population outcomes. Using innovation, integration, and data, links the quality management activities to business goals. Health Care Quality… more
- Highmark Health (Charleston, WV)
- …to regularly contact. These include physicians, practice administrators, specialists, behavioral health providers, ancillary service providers, hospital ... including NCQA accreditation, and the creation of an accurate HEDIS data set. + Assist in the development of...health care management roles, and involvement with formal quality and/or utilization management programs are required + 5… more