- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Senior Data and Reporting Professional generates scheduled and ad hoc reports ... of large datasets from internal and external sources. The Senior Data and Reporting Professional...experience in healthcare. + Must have experience working with HEDIS measures in Managed Care settings. + Advanced proficiency… more
- Ventura County (Ventura, CA)
- …health, preventing diseases, and maintaining well-being; + Assumes responsibilities related to HEDIS , including data collection, reporting , and ensuring ... exceeding NCQA requirements, including project management responsibilities; + Experience related to HEDIS , including data collection, reporting , and ensuring… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** As a Stars Senior Data Analyst, your main focus will be to improve publicly reported rates and close the gaps in Stars ... You will achieve this through the effective use of data analytics, technology, and reference material. Reporting ...Doing:** + Knowledge of Medicare Star Rating methodology; NCQA HEDIS measures; CAHPS and HOS surveys + Intermediate to… more
- Humana (Columbus, OH)
- …provide data for HEDIS and other healthcare quality measures. The Data and Reporting Lead will create, review, stratify and identify opportunities to ... scope and complexity ranging from moderate to substantial. The Data Reporting Lead will pull healthcare ...Clinical Performance, key benchmarks and improve Quality outcomes, (ie, HEDIS , NCQA, CAHPS, PIPS and state regulatory requirements) +… more
- Walgreens (Deerfield, IL)
- …and projects. Supports long term and ad-hoc data ETL and data warehousing activities to meet Walgreens Health reporting and analytics deliverables. ... + Designs, develops, and deploys dimensional databases and data pipelines to support reporting and analytics projects. + Creates data staging and pre… more
- Humana (Columbus, OH)
- …a data intelligence and reporting team that is focused on such data sets as Medicare Stars, HEDIS , clinical programs, CMS, etc. This is your opportunity ... + 2 or more years of technical experience in data reporting + Comprehensive knowledge of Microsoft...for various healthcare sectors + Experience with Stars or HEDIS + Proficiency in understanding Healthcare related data… more
- Community Clinic Inc. (Silver Spring, MD)
- Position Summary The Senior Clinical Analyst has responsibility for data analytics, data provisioning, ad hoc analysis, and assisting the quality team in ... identifying data -driven improvement strategies and implementation plans which result in...tool and/or eClinicalWorks (eCW) preferred. + Familiar with HRSA, HEDIS , Government HealthCare practices, and general Population Health Analytics.… more
- Centene Corporation (Springfield, IL)
- …resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS . + Under general guidance form Senior Quality Practice Advisors ... regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures,...identified databases and ensure accuracy in medical records for data collection, DE and reporting . + Performs… more
- Point32Health (Canton, MA)
- …Quality Informatics, the Analytic Manager will support HEDIS and quality measurement reporting and data analysis functions using SAS, SQL, and other software ... initiatives with individualized data as needed. + Responsible for evaluation of HEDIS data , including HEDIS rate investigations and root cause analyses… more
- The Cigna Group (Charlotte, NC)
- The Provider Performance Enablement (PPE) Senior Manager is an integral part of a cross-functional, collaborative organization (which includes Market Provider ... Cross-Segment Contracting, Provider Relations, and Network Development & Solutions). Reporting to the Medicare Market President/Operations Senor Director, this… more
- Providence (Seattle, WA)
- **Description** **THE ROLE** The Senior Director Utilization Management & Denials - Administration is 100% remote. The role requires a broad knowledge and focus on ... and facilitate program integration. + Accountable for budgetary compliance in departments reporting to the role; Performs at agreed upon metrics for departments.… more
- Honor Community Health (Pontiac, MI)
- …including - + Annual Quality Work Plan + Quality Improvement Plan + Reporting calendar + Ensures timely data collection, aggregation, benchmarking, analysis, and ... to Health Resources and Services Administration (HRSA) requirements, The Healthcare Effectiveness Data and Information Set ( HEDIS ), Centers for Medicare and… more
- Molina Healthcare (AZ)
- …**Preferred Experience** + 1 year of experience in Medicare and in Medicaid. + HEDIS reporting or collection experience. + Experience developing and / or ... for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key...analysis of credentialing files, the analysis of quality metric data , including, but not limited to, HEDIS ,… more
- Molina Healthcare (Albuquerque, NM)
- …**Preferred Experience** + 1 year of experience in Medicare and in Medicaid. + HEDIS reporting or collection experience. + Experience developing and / or ... for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key...analysis of credentialing files, the analysis of quality metric data , including, but not limited to, HEDIS ,… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …with respect to quality and utilization performance standards. Develops standard reporting and analytics to support Value Based Contracting (VBC) initiatives. ... cost analysis. **Provider Network Performance Analyst I** + Gathers and maintains data from multiple sources and conducts quality assurance to identify potential… more
- Universal Health Services (Reno, NV)
- …that the members' risk scores are optimized and compliant with regulatory reporting standards. The Senior Director has programmatic oversight and responsibility ... analytic and reporting tools, and assists in the development of data collection systems and workflows to fulfill CMS and quality measurement requirements.… more
- Trinity Health (Clive, IA)
- …all statewide value based contracts, including contract terms, performance, payer reports, data , etc. + Oversee payer reporting requirements including manual and ... (ie reporting , analysis, operational insights) required. In-depth knowledge of HEDIS measures strongly preferred. Strong skills in MS Office suite (Excel,… more
- CVS Health (Richmond, VA)
- …oversight of regulatory requirements.* Deep understanding of health plan operations and data , including Quality and NCQA HEDIS , provider contracting & ... of the Aetna Better Health of Virginia leadership team, reporting to the CEO. This role is responsible for...Models (APMs). The Sr. Director will be the primary senior leader responsible for ongoing VBP related communications and… more
- Emanate Health (Covina, CA)
- …as HEDIS , STARS,ICD-10, HCC/RAF, and a proficiency in analytic reporting required. **Minimum License Requirement :** CPC, CRC and project management ... The Director Clinical Quality & Risk Management is a senior role at Emanate Health and a member of...Emanate Health and a member of the leadership team. Reporting to the Vice President of Clinical Integration and… more
- Molina Healthcare (Las Vegas, NV)
- …of experience in Medicare and in Medicaid. + Experience with data reporting , analysis and/or interpretation. **Preferred License, Certification, Association** ... of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement… more