- Somatus (Mclean, VA)
- …ensure optimal processes are effective to address gaps in care. + Support the HEDIS manager to conduct meetings with operations to review performance. + ... + Organize and maintain a plan of action to improve HEDIS scores + Support the Manager to request and evaluate reports for member compliance and improvement… more
- CVS Health (Springfield, IL)
- …heart, each and every day. **Position Summary** Manages all internal aspects of HEDIS MRRV and YRMRRV to ensure compliance to corporate standards and timelines. ... Job Duties & Responsibilities:** + Develops, executes and coordinates annual HEDIS project plans in alignment with QAPI and Quality/Population Health program… more
- Somatus (Mclean, VA)
- …partner health plan quality programs. + Interface with data support, quality assurance team, HEDIS Quality Manager , and IT to collect data and maintain the ... well-being + Community engagement opportunities + And more! The HEDIS Coordinator I will perform the functions related to...entering of medical records and service data according to HEDIS / Somatus Technical Specifications. The primary focus of… more
- AmeriHealth Caritas (Newtown Square, PA)
- **Role Overview** Manages Healthcare Effectiveness Data and Information Set ( HEDIS ) planning, data collection, quality control, analysis, and reporting to meet all ... regulatory. Applying both business knowledge and technical expertise to supports HEDIS strategies, goals, and initiatives at corporate and plan-level.; **Work… more
- CVS Health (Nashville, TN)
- …Leverages technology and data to improve healthcare outcomes by designing, implementing, and maintaining health information systems, analyzing quality healthcare ... data, and applying statistical analysis to create effectiveness analyses and other health outcomes analyses. Applies expertise in healthcare and information technology to ensure efficient data management, promote data-driven insights, and enhance the delivery… more
- Centene Corporation (Phoenix, AZ)
- …functional process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities + Manager the ... or Nevada.** **Position Purpose:** Supervise and coordinate team ensure HEDIS data accuracy and reporting, including investigations, auditing, and improvement… more
- Molina Healthcare (Boston, MA)
- …pursuit and collection of medical records and other data in collaboration with other HEDIS staff. * Assists the Manager and Supervisor(s) and / or performs ... **JOB DESCRIPTION** **Job Summary** Molina's HEDIS /Quality Improvement Medical Records Collector will work collaboratively...system retrieval and direct onsite pick up, for the HEDIS projects. **Job Duties** * Under the direction of… more
- Molina Healthcare (TX)
- …Lead Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The ... + Performs the lead role in the coordination and preparation of the HEDIS medical record review which includes ongoing review of records submitted by providers… more
- Elevance Health (Atlanta, GA)
- **Clinical Quality Director** **- Stars/ HEDIS ** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and office). The ... record of driving 4- to 5-Star performance through successful Stars and HEDIS gap closure initiatives, with experience spanning diverse population segments and… more
- CVS Health (Springfield, IL)
- …clinical and operational performance improvement initiatives to achieve organizational HEDIS and STARs goals + Develops, executes, analyzes and evaluates ... programmatic and workgroup interventions for improvement of HEDIS metrics via POSC + Leads project management team...Quality or Case Management experience + Strong knowledge of HEDIS measures and requirements + Excellent data analytics and… more
- Providence (WA)
- **Description** **Quality Program Manager - Medicare Advantage Stars** **The Quality Program Manager - Medicare Advantage Stars is tasked with serving as a** ... strategies that result in improved Star ratings.** **The Stars Quality Program Manager will:** + Develop and implement strategies to improve Medicare Advantage Star… more
- LifePoint Health (Las Cruces, NM)
- …visits, colonoscopies, cervical cancer screenings, and mammograms. The Quality Practice Manager (QPM) will collaborate with employed practices to achieve local ... The QPM establishes and maintains practice/provider relationships, presenting, practices HEDIS , STARS, and RAF training and planning, and contract performance… more
- Apicha Community Health Center (New York, NY)
- …for underserved and vulnerable populations. Position Summary The Population Health Manager collaborates with a multidisciplinary staff to meet Population Health and ... the mission of Apicha and its strategic goals. The Population Health Manager supports the implementation of strategies to drive clinical transformation toward… more
- Molina Healthcare (Louisville, KY)
- **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success. * Partner with other teams to ensure data quality… more
- Praxis Health (Portland, OR)
- …healthcare clinic, and we're searching for an experienced LPN or MA Care Manager to join our advanced primary care team. This is a high-impact, in-house ... + Coordinate with centralized PXH/Regence teams to drive performance in: + HEDIS metric tracking + Transitional Care Management (TCM) + Annual Wellness Visit… more
- McLaren Health Care (Flint, MI)
- We are looking for a Manager , Quality, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of McLaren ... Performance Plan (QPIP). Manages the Healthcare Effectiveness Data and Information Set ( HEDIS ) process. Facilitates the delivery of medical care in a cost efficient… more
- Molina Healthcare (Las Vegas, NV)
- **Job Description** **Job Summary** The Manager , Quality Program Management and Performance oversees and leads activities to maintain compliance with state ... Health, Health Administration, Social Work, or related field + HEDIS reporting or collection + CAHPS improvement experience +...(RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
- Centene Corporation (Baton Rouge, LA)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
- Centene Corporation (Montgomery, AL)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
- Centene Corporation (Atlanta, GA)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost (MLR) and utilization. Account management experience strongly preferred.… more