• Medicare Star Business Strategy Plan…

    Elevance Health (Woodland Hills, CA)
    …preferred. + Experience in Medicare, Medicare Star , clinical quality , HEDIS (R), health plan operations, or healthcare quality improvement preferred. ... **Medicare Star Business Strategy Plan Director ​** **Location:** This...and customer insight work, with a focus on clinical quality and HEDIS (R) performance. **How you will… more
    Elevance Health (05/21/24)
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  • SHP Pharmacy Quality Assurance - Auditing…

    Marshfield Clinic (Marshfield, WI)
    …for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set ( HEDIS ), and 5 Star Quality Measures. Position can be remote or ... National Committee for Quality Assurance (NCQA) or Healthcare Effectiveness Data and Information Set ( HEDIS )...improve Healthcare Effectiveness Data and Information Set ( HEDIS ) standards and five star ratings. 5.… more
    Marshfield Clinic (05/15/24)
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  • Quality Coordinator

    Universal Health Services (Riverside, CA)
    …can provide a place for you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward. We are ... working to change lives and transform the delivery of healthcare . Riverside Medical Clinic is the best place to...all data submitted to the health plan meets the HEDIS / Star technical specifications for medical… more
    Universal Health Services (05/18/24)
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  • Clinical Quality Program Manager II (Cahps)

    LA Care Health Plan (Los Angeles, CA)
    …Required: At least 5 years experience in a health plan specializing in healthcare quality , informatics, QI initiatives and analytics. Experience in implementing ... to quality excellence in Centers for Medicare and Medicaid Services (CMS) Five- Star Rating System and Marketplace Exchange Quality Rating Systems (QRS). The… more
    LA Care Health Plan (04/10/24)
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  • Prospective Program Solutions & Performance…

    The Cigna Group (Westerville, OH)
    …CMS Risk Adjustment and HCC coding process and quality including Medicare Star Ratings and HEDIS + Strongly preferred experience with EMR implementations, ... needs identified. + Function as a Risk Adjustment and Quality SME to support engagement with market and matrix...programs, visit Life at Cigna Group . **About Cigna Healthcare ** Cigna Healthcare , a division of The… more
    The Cigna Group (05/09/24)
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  • LPN/LVN or RN Value Based Care Nurse- Mobile, AL…

    The Cigna Group (Mobile, AL)
    …and manage relationships with participating provider practices. Maintain detailed understanding of HEDIS / STAR / CAHPS performance measures. Develop and maintain ... monitor and evaluates options and services in order to facilitate appropriate healthcare outcomes for customers. **Responsibilities:** + Identifies Quality gaps… more
    The Cigna Group (03/26/24)
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  • Regional Practice Manager

    VIP Care (Tampa, FL)
    …(ie: data mining relevant to appointments, referrals, etc.) + Assist with closing identified HEDIS gaps and achieving specified Star measures + Work with the ... a reliable team that shares their mission of providing 5- star service that always puts patient care and outcomes...healthy. Be part of a team that is transforming healthcare one patient at a time. We take great… more
    VIP Care (04/08/24)
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  • Quality Improvement Specialist Senior

    Centene Corporation (Carson City, NV)
    …+ Conducts vendor oversight and management. + Develops targeted activities to improve Star Ratings, HEDIS , CAHPS, HOS, provider satisfaction and other identified ... adoption to assure quality and effectiveness of health care delivery and/or healthcare services provided to members. + Performs all other duties as assigned. +… more
    Centene Corporation (05/15/24)
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  • RN Nurse Case Management Senior Analyst - Greater…

    The Cigna Group (Harlingen, TX)
    …and manage relationships with participating provider practices. Maintain detailed understanding of HEDIS / STAR performance measures. Develop and maintain a ... process to ensure all customers in participating provider practices meet all quality metrics. Responsible for coordinating the delivery of cost-effective, quality more
    The Cigna Group (05/16/24)
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  • LPN/LVN or RN Nurse Case Management Senior Analyst…

    The Cigna Group (Hattiesburg, MS)
    …and manage relationships with participating provider practices. Maintain detailed understanding of HEDIS / STAR performance measures. Develop and maintain a ... process to ensure all customers in participating provider practices meet all quality metrics. Responsible for coordinating the delivery of cost-effective, quality more
    The Cigna Group (05/09/24)
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  • Program Manager IV - Value Based Performance

    Cleveland Clinic (Cleveland, OH)
    …of ACO, Medicaid, and Medicare Advantage quality measures, NCQA and HEDIS standards, and Medicare Advantage star ratings gained through experience preferred. ... Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare . Cleveland Clinic is recognized as one of the top hospitals in… more
    Cleveland Clinic (04/25/24)
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  • Bilingual Clinical Office Manager

    VIP Care (Ocoee, FL)
    …building their careers with a reliable team that shares their mission of providing 5- star service that always puts patient care and outcomes first. At VIPcare, it's ... healthy. Be part of a team that is transforming healthcare one patient at a time. We take great...and clinical role and is responsible for providing 5 Star Service in assisting physicians in the management of… more
    VIP Care (05/18/24)
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  • Nurse Practitioner/APRN

    EasyHealth (Brooklyn, NY)
    …have license/certification: APRN, Certified Nurse Practitioner + Knowledge of the HCC model, HEDIS , and STAR quality measures + Effectively communicate with ... technology and compassion. At EasyHealth, we believe in advancing healthcare with a member-first approach. We're shaping the future...with a member-first approach. We're shaping the future of healthcare , one Annual Wellness Visit at a time. About… more
    EasyHealth (05/08/24)
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  • Nurse Practitioner/Physicians

    EasyHealth (Ponce, PR)
    …Must have license/certification: APRN, Certified Nurse Practitioner + Knowledge of HCC model, HEDIS and STAR quality measures + Effectively communicate with ... technology and compassion. At EasyHealth, we believe in advancing healthcare with a member-first approach. We're shaping the future...with a member-first approach. We're shaping the future of healthcare , one Annual Wellness Visit at a time. About… more
    EasyHealth (05/05/24)
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  • Nurse Practitioner

    EasyHealth (DE)
    Elevate Healthcare as a Nurse Practitioner - Transform Patient...medicine specialty + Familiarity with the HCC model and quality HEDIS and other STAR ... balance with Easy Health's innovative and flexible approach to healthcare . As a Nurse Practitioner at Easy Health, you...in performing comprehensive assessments such as Annual Wellness & Quality Gap Care visits for our members in their… more
    EasyHealth (05/21/24)
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  • Director, Pharmacy Government Programs (Hybrid)

    CareFirst (Baltimore, MD)
    …pharmacy government programs to reduce pharmacy spend, total cost of care, improve Star and HEDIS scores, and improve health outcomes, Support programs from ... committee's including but not limited to Pharmacy &Therapeutics Committee, Quality Improvement Committee, and Vendor Management Committee. Prepares for annual… more
    CareFirst (04/19/24)
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