- Cambia Health Solutions, Inc (Renton, WA)
- …to drive performance improvements in critical objectives such as population health management, Medicare Stars , and Risk Adjustment.Here are some of the exciting ... our team as a Government Programs Provider Performance Director!Preferred Key Experience : Familiarity with Medicare Advantage and its business modelExperience… more
- CVS Health (Hartford, CT)
- …care more personal, convenient and affordable. Position SummaryAs a member of the Medicare Stars Member Experience team, the Manager of Business ... of actions supporting broad-based, regional and local actions to maximize Medicare member experience and engagement for the enterprise.Aetna Medicare… more
- Elevance Health (Boston, MA)
- …Skills, Capabilities and Experiences:** + Medicare , Medicaid, Commercial Healthplan experience + STARS and HEDIS expertise and understanding patient ... quality + Experience leading provider group/health plan to a higher STARS rating. + Certified Professional Healthcare Quality (CPHQ). + MS/MA For candidates… more
- Humana (Tallahassee, FL)
- …STARS Improvement Analyst develops, implements, and project management of the company's Medicare /Medicaid Stars Program. Contributes to all Stars quality ... with multiple departments a plus + Understanding of CMS Stars , performance measures, HEDIS knowledge and experience ...and data visualizations + Visio and Access (data analysis, experience with relational databases) + Medicare and/or… more
- Commonwealth Care Alliance (Boston, MA)
- …is easily understood and actionable by key stakeholders (Market, Quality, Pharmacy, Member experience team) in alignment with clearly defined analytic/reporting ... analyzing quality improvement measures in a health plan. + Experience working in Stars (HEDIS, HOS, CAHPS)...understood and actionable by key stakeholders (Market, Quality, Pharmacy, Member experience team) in alignment with clearly… more
- CVS Health (Richmond, VA)
- …or auditing programs + 1-3 years Medicare managed care experience + Experience with Medicare STARS and Part D Formulary benefits + Knowledge of ... other clinical programs + Communicate to providers, pharmacies, and members on quality, STARs , or FWA indicators for Medicare programs + Provide clinical… more
- The Cigna Group (Miramar, FL)
- …+ 6+ years of direct provider-facing experience or direct health plan experience with STARS , HEDIS, Risk Adjustment and medical expense reduction, specific ... Summary** The Provider Performance Enablement (PPE) Manager is a key member of a cross-functional, collaborative organization (which includes Market Provider… more
- The Cigna Group (Houston, TX)
- …of services in the assigned **Houston, TX territory** as evidenced by physician and member satisfaction, improvements on Stars and NPS score. Managing our Costs ... **The Provider Performance Lead Analyst is a key member of the market that assists in the...direct provider-facing experience or direct health plan experience with STARS , HEDIS, Risk Adjustment and… more
- Elevance Health (Middletown, NY)
- …or ask you for payment as part of consideration for employment. **RVP Medicare Market President (Northeast)** + Job Family: BUS > Strategy, Planning & Execution ... + New York + Maine **Description** **RVP & President Medicare Market (Northeast Region)** **Location:** This role requires the...and to grow CSNP, as well as to drive Stars performance. + Oversee and participate in the development… more
- Elevance Health (Columbus, OH)
- …a check, or ask you for payment as part of consideration for employment. **RVP Medicare Market President (OH)** + Job Family: BUS > Strategy, Planning & Execution + ... + OH, MASON + Ohio **Description** **RVP & President Medicare Market (Ohio)** **Location:** This role requires the leader...and to grow CSNP, as well as to drive Stars performance. + Oversee and participate in the development… more
- The Cigna Group (Bloomfield, CT)
- …2+ years' experience in customer service, claims, and/or payor related experience + Demonstrated knowledge of contracting process, Medicare fee schedules, ... Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides...key program performance metrics, such as utilization, coding, and STARs /quality performance + Assist in the STARS … more
- Health First (Rockledge, FL)
- …to accrediting and regulatory agency inquiries and audit requests including CMS, Medicare Stars , NCQA, and any other regulatory requirements. 7. Facilitate ... strategic plans to support population health goals and initiatives to meet member needs across the continuum of care, including Integrated Care Program clinics.… more
- CVS Health (Columbus, OH)
- …and engaging decisionmakers. + Identification of cross-enterprise initiatives necessary to achieve Stars and Member Experience objectives. + Responsibility ... Providing information, expert opinion and thought leadership needed to support the attainment of Stars and Member Experience Objective. + May represent the … 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 to join ... + Experience creating analytics solutions for various healthcare sectors + Experience with Stars or HEDIS + Proficiency in understanding Healthcare related… more
- The Cigna Group (Charlotte, NC)
- …8+ years of direct provider-facing experience or direct health plan experience with STARS , HEDIS, Risk Adjustment and medical expense reduction, preferably ... (which includes Market Provider Performance, Sales, Health Services, Clinical, Stars & Risk Adjustment, Finance, Marketing, Cross-Segment Contracting, Provider...specific to Medicare Advantage + **Leadership:** 3+ years management … more
- LA Care Health Plan (Los Angeles, CA)
- …of business. Experience in improving Stars and Quality Measures. Experience in Medicare Advantage, with experience serving duals population. Direct ... operational processes that impact quality scores, enrollment, revenue and member retention. Design appropriate mitigation and contingency plans. Lead... experience in Medicare and Duals program administration including stars ,… more
- Humana (Columbus, OH)
- …courses of action. + Ability to handle multiple priorities. **Preferred Qualifications** + Medicare Risk Adjustment and/or Stars experience . + Experience ... an organization responsible for improving health outcomes and advancing the care experience of our members and provider partners through integrated risk adjustment… more
- LA Care Health Plan (Los Angeles, CA)
- …with experience serving duals population. Direct experience in Medicare and Duals program administration including stars , quality, financial performance ... cycle activities and specific strategic initiatives in support of optimizing the member experience while managing the ongoing evolution and strategic direction… more
- The Cigna Group (Bloomfield, CT)
- …delivery of services in the assigned territory as evidenced by physician and member satisfaction, improvements on Stars and NPS score. Managing our Costs ... **Role Summary** The Provider Performance Lead Analyst is a key member of the market that assists in the growth and development of the provider network. The Lead… more
- Molina Healthcare (Topeka, KS)
- …for partnering with MHI RQES and VP Stars in developing the local Medicare Stars work plan and executes on interventions that will improve CAHPS, HEDIS ... * Responsible for partnering with MHI RQES and VP Stars in managing MMP quality withhold revenue in MMP...program materials, templates or policies. * Serves as a member of the State's Provider Engagement team for large,… more
