- Highmark Health (Wilmington, DE)
- …interpret PCP and facility value based reimbursement reports in the areas of National Quality Standards like NCQA, HEDIS , NQF, PQRS etc., and cost and ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This is...utilization management, immunizations, specialty pharmacy, Medicare Stars, and Medicaid HEDIS to strategies designed to promote the Organization's value… more
- AmeriHealth Caritas (Philadelphia, PA)
- …managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover ... & Providers by metric and performance requirements, identifies members with Care Gaps/ HEDIS -related health conditions, and assists them in accessing care through… more