- CareFirst (Baltimore, MD)
- …population health expert to engage members to drive improvement in NCQA HEDIS measure performance. Provides advanced knowledge to support effective partnership with ... is accurate and reflective of true managed care needs. Utilizes extensive HEDIS and coding knowledge, combined with medical policy, credentialing, and contracting… more
- AmeriHealth Caritas (Manchester, NH)
- **Provider Communications Specialist Sr ( Hybrid )** Location: Manchester, NH Primary Job Function: Marketing & Communications ID**: 29333 **Job Brief** This ... hybrid opportunity will be responsible for creating communications for...project deadlines will be required. **Responsibilities:** The Senior Communications Specialist Senior is responsible for all communication tasks that… more
- The Cigna Group (Philadelphia, PA)
- Job Description: Coding Education Specialist (AHIMA or AAPC certified) - Philadelphia, PA We value our talented employees, and whenever possible strive to help one ... Professional Coder (CPC) Certified Risk Adjustment Coder (CRC) Certified Coding Specialist for Providers (CCS-P) Certified Coding Specialist for Hospitals… more
- The Cigna Group (Bloomfield, CT)
- …like, obtaining medical records, Healthcare Effectiveness Data and Information Set ( HEDIS ) measures, Risk Management and services that impact Cigna's overall STARs ... ratings. The individual will lead and support negotiations with suppliers to secure competitive prices, improve delivery, and achieve favorable terms to Cigna. Understanding of business process, legal contracts, and financial acumen is desired. This resource… more
- Centene Corporation (Baton Rouge, LA)
- …all clinical initiatives including, case and disease management, behavioral health and HEDIS outcome measures + Evaluate the analysis and responses on all quality ... Advanced Practice Registered Nurses (must be a nurse practitioner specialist in Adult Psychiatric & mental Health, Family Psychiatric...holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will… more
- Centene Corporation (Springfield, IL)
- …to competitive benefits including a fresh perspective on workplace flexibility. ** Hybrid Position: Provider visits in the Southern IL area** **Position Purpose:** ... sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record… more
- Corewell Health (Grand Rapids, MI)
- …and cost savings opportunities. + Supports clinical initiatives related to NCQA, HEDIS , CAHPS, STAR measures, and other clinical quality and programs. Adheres to ... MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who… more
- Centene Corporation (Phoenix, AZ)
- …HBR (Health Benefits Ratio) analyses, Health Information data Information Set ( HEDIS ) analyses, and create reports for provider Review provider performance by ... paid time off plus holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will be adjusted based on an… more
- Highmark Health (Dover, DE)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This is a hybrid role requiring 3 days a week in office or in a provider office within the ... utilization management, immunizations, specialty pharmacy, Medicare Stars, and Medicaid HEDIS to strategies designed to promote the Organization's value based… more