• Senior Stars Improvement

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Senior Stars Improvement , Clinical Professional responsible for the ... management oversight of the company's Medicare/Medicaid Stars Program. The Senior Stars Improvement , Clinical Professional work assignments involve… more
    Humana (10/15/25)
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  • Senior Nurse STARS

    Humana (Oviedo, FL)
    …a part of our caring community and help us put health first** The Nurse Senior Stars Improvement , Clinical Professional/ Consultant contributes to the ... management of the company's Medicare/Medicaid Five-Star Quality Rating System. The Senior Stars Improvement , Clinical Professional works directly with… more
    Humana (10/03/25)
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  • AVP, Clinical Stars & Quality…

    Molina Healthcare (Spokane, WA)
    …to support program regulations. **Job Duties** The Associate Vice President is a key Clinical Stars & Quality Improvement (QI) leader within the organization ... enterprise-wide. This position advises senior management, other corporate departments, and Molina health plans...CAHPS improvement experience + Stars improvement experience + Experience with clinical intervention… more
    Molina Healthcare (08/28/25)
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  • Senior Project Manager of HEDIS and CMS…

    UCLA Health (Los Angeles, CA)
    Description UCLA Health is seeking an experienced Senior Project Manager to lead critical healthcare quality initiatives, including CMS Star Ratings and HEDIS ... submission, audits, and hybrid chart abstraction + Collaborate with clinical , operations, and compliance stakeholders + Facilitate cross-functional workgroups to… more
    UCLA Health (08/21/25)
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  • Senior Clinical Strategist

    CVS Health (Albany, NY)
    …hours. No nights, no weekends and no holidays. **Position Summary** The Senior Clinical Strategist works with assigned Aetna Medicare Provider Collaboration ... also focus on improvements in utilization and cost. The Senior Clinical Strategist works to drive ...Data Team, Medical Operations and others on initiatives for Stars /quality improvement **Required Qualifications** - Registered Nurse… more
    CVS Health (10/15/25)
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  • Bilingual Quality Improvement RN - South

    CenterWell (Tampa, FL)
    **Become a part of our caring community and help us put health first** The Stars Improvement , Clinical Professional (RN) is responsible for the development, ... Stars Program in the North Florida market. The Stars Improvement , Clinical Professional (RN)...insurance and many other opportunities. **About Us** About Conviva Senior Primary Care: Conviva Senior Primary Care… more
    CenterWell (10/08/25)
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  • CAHPS Operations & Improvement Lead Product…

    Humana (Louisville, KY)
    …on Stars and other quality metrics. + Lead continuous improvement initiatives, leveraging data analytics and customer feedback to enhance survey effectiveness ... comprehensive analytics that are meaningful to develop forecasting and targeted improvement in healthcare quality with our Medicare population. This role will… more
    Humana (09/25/25)
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  • AVP, Quality Improvement (Remote…

    Molina Healthcare (Racine, WI)
    …to learn new information systems and software programs. **Preferred Experience** + CAHPS improvement experience + STARS improvement experience + State QI ... quality metrics like PQI (hospital), NQF-sanctioned measurement. + Experience with clinical intervention concepts, design of quality improvement projects (QIPs),… more
    Molina Healthcare (09/18/25)
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  • Senior Medical Director, Aetna Better…

    CVS Health (Springfield, IL)
    …LTSS and Health Equity in order to identify risks and opportunities for improvement . Serve as clinical executive leader for State regulators, providers, and ... with heart, each and every day. **Position Summary:** The ABHIL Chief Psychiatrist ( Senior Medical Director) will serve as a strategic and operational partner to the… more
    CVS Health (09/10/25)
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  • Associate Center Clinical Director

    ChenMed (Margate, FL)
    …+ Knowledge and experience in a managed care delivery system. + Knowledge of clinical outcomes and quality improvement processes. + Experience of population risk ... center. The incumbent in this role is accountable for maximizing overall clinical value while engaging physicians to improve clinical quality, efficiency,… more
    ChenMed (09/09/25)
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  • Senior Integrated Clinic Pharmacist

    CenterWell (Peoria, AZ)
    …patients + Document all activity within clinic EMR and other required pharmacy or clinical management systems + Support CMS Stars and HEDIS quality measures for ... and help us put health first** We are seeking an ambitious and goal-oriented Clinical Pharmacist with over 5 years of experience to join our primary care… more
    CenterWell (08/27/25)
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  • Provider Transformation Specialist (RN- Western…

    Highmark Health (Buffalo, NY)
    …the other members of the value-based reimbursement team, provider relations, senior markets, analytics, actuary and key internal/external stake holders to provide ... not limited to: Advising primary care practices, physicians, nurses and other clinical staff to assist them on their conversion to value-based care; Dissemination… more
    Highmark Health (10/15/25)
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  • Associate Medical Director

    CenterWell (Columbia, SC)
    …by staffing levels throughout the year + Support clinical quality performance improvement in areas such as MRA, Stars , and prevention of unnecessary ... such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical initiatives + Champion our senior -focused primary care strategic… more
    CenterWell (09/25/25)
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  • Manager, Patient Relations and Experience

    Beth Israel Lahey Health (Beverly, MA)
    …and Patient Safety, and is responsible for Patient Experience measurement and improvement , the Patient Complaint process and oversight of the Patient Relations ... and applicability. This position will facilitate Patient & Family Experience improvement initiatives, including those associated with PEX health equity. As part… more
    Beth Israel Lahey Health (09/26/25)
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  • Quality Specialist

    Rochester Regional Health (Rochester, NY)
    …organization to enhance patient outcomes and quality performance. RESPONSIBILITIES: Quality Improvement : + Collaborate with clinical and operational leaders to ... performance improvement projects. + Participate and collaborate with performance improvement teams. + Provide recommendations to senior leadership on quality… more
    Rochester Regional Health (09/24/25)
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  • Associate Professor, Academic Clinician, Associate…

    University of Pennsylvania (Philadelphia, PA)
    …has a 40-year track record of using health information technology to support clinical practice, quality improvement , and research, starting with the adoption of ... Philadelphia (CHOP) seeks applicants for the role of a senior physician informatics leader to oversee the ambulatory EHR...the outcomes of this work (health IT implementation, quality improvement projects, and collaboration with clinical &… more
    University of Pennsylvania (09/02/25)
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  • Chief Academic Officer, Community Medical Center

    RWJBarnabas Health (Toms River, NJ)
    …to the RWJBH system for Medical Education. The CAO will serve as the senior research administrator and coordinate clinical research activities at their campus. ... Quality Improvement : + Work closely with quality improvement teams to integrate academic advancements into clinical...directors. + Participate in the Leapfrog Group, Vizient, CMS stars , US News and World Report and other institutional… more
    RWJBarnabas Health (10/14/25)
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  • Medical Director - Dsnp/MMP

    CVS Health (Tallahassee, FL)
    …heart, each and every day. **Primary Responsibilities:** * Responsible for clinical oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / ... Medicare-Medicaid Plan) * Develop and lead clinical strategy and objectives for the DSNP/FIDE populations, including...with data interpretation. * Effectively communicate these finding to Senior Management and staff at all levels. * Develop… more
    CVS Health (10/15/25)
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  • Data Science Analyst III - Mount Sinai Health…

    Mount Sinai Health System (New York, NY)
    **Job Description** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization to develop sophisticated analytics to ... State Medicaid and CMS Medicare regulations and related reporting requirements, such as STARS ,QARR, MMCOR, MEDS, RAPS and HEDIS is a strong plus. + Experience… more
    Mount Sinai Health System (10/08/25)
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  • Provider Engagement Executive

    Humana (Richmond, VA)
    improvement . + Experience with value-based contracting + Diverse clinical experience, including experience working with behavioral health providers, OB/GYNs, and ... such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding,… more
    Humana (09/27/25)
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