- Humana (Columbus, OH)
- …reports and data management to support Quality Improvement within the Medicaid product line. + Integrates data from multiple sources to produce requested or ... experience in healthcare. + Must have experience working with HEDIS measures in Managed Care settings. + Advanced proficiency...etc.) **Additional Information** This position is open to working remote **Work at Home Criteria** ** ** To ensure… more
- Highmark Health (Dover, DE)
- …record review and coding, and member and provider satisfaction for all product lines. Recommends and implements process improvements related to the potential of ... quality medical care and service to members and to improve documentation of these...communicate results. Conduct continuing education to providers on STARS, HEDIS , and HCC Coding. Conduct re-audits as needed. +… more
- Elevance Health (Woburn, MA)
- …**Director National Quality Management** Location: This position will work a hybrid model ( remote and office). The Ideal candidate will live within 50 miles of one ... and leads an industry leading quality improvement program for the Wellpoint product in Massachusetts ensuring that all performance guarantee metrics and client… more
- WellSense (Boston, MA)
- …standards . Collaborates cross-functionally with internal stakeholders, (customer service , marketing, sales, product , finance, utilization management, ... making in accordance with the appropriate state and federal coverage determinations, product benefits, internal medical policies and InterQual criteria . The senior… more