- Molina Healthcare (OH)
- …skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis, and/or ... intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions… more
- Humana (Louisville, KY)
- …health outcomes, optimized cost performance and measurable program value across Medicaid . This executive leverages advanced analytical, data science, and ... caring community and help us put health first** The Vice President, Medicaid Clinical Economics & Quality provides strategic and operational leadership for clinical… more
- Molina Healthcare (Columbus, OH)
- …corresponding tracking of progress and impact of such interventions. + Assist retrospective HEDIS rate tracking and supplemental data impact reporting. + Develop ... automated analytical as well as Reporting modules related to Quality/ HEDIS for Medicaid , Marketplace and Medicare/MMP. +...Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS… more
- CVS Health (Springfield, IL)
- …and methods to continuous quality improvement and methodical evaluation of HEDIS and Population Health interventions. Synthesizes salient data analytics ... highlight successes, opportunities, and recommendations for performance improvement by HEDIS measure and subpopulation level. Leads data ...by Aetna Better Health of Illinois + Leads custom data insights generation for senior leadership and… more
- Humana (Olympia, WA)
- …a part of our caring community and help us put health first** As a Senior Network Performance Professional at Humana, you will play a pivotal role in enhancing ... as an expert on the Stars/Quality program, educating physician groups on HEDIS , patient safety, and patient experience. Collaborate to develop tailored action plans… more
- Adecco US, Inc. (Minneapolis, MN)
- …years in business analysis and data analysis (preferably in HEDIS , provider data , claims data , or Medicare/ Medicaid ). * 2+ years in business analysis ... Adecco is currently assisting a local Customer in their search for Senior Business Analyst in Remote. This is a great opportunity to further your existing skills as… more
- MyFlorida (Gainesville, FL)
- SENIOR CLERK - 64026875 Date: Dec 1, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 866071 Agency: Department of Health Working Title: SENIOR CLERK - 64026875 Pay Plan: Career Service Position Number: 64026875… more
- Fallon Health (Boston, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... and nursing assessment skills, may complete NaviCare Program Assessment Tools and Minimum Data Set Home Care (MDS HC) Form when a member's medical/functional status… more
- Molina Healthcare (Rockford, IL)
- …**Preferred Experience** + 1 year of experience in Medicare and in Medicaid . + Experience with data reporting, analysis and/or interpretation. **Preferred ... programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities;… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization to develop sophisticated ... strategic planning, decision-making, goal setting, and effective performance measurement. The Data Science Analyst III demonstrates sound and a more advanced… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …for all enterprise quality performance programs across the organization's Medicare, Medicaid , ACA, and Commercial lines of business. This position leads the ... and organizational strategy. The Director oversees programs such as Medicare Stars, HEDIS , CAHPS/HOS, and other quality measures that are required by regulation or… more
- CenterWell (Jupiter, FL)
- …health + HEDIS and Stars performance + Operational improvements + Data sharing and connectivity + Documentation and coding + Additional areas related to ... for the development, implementation and management oversight of the company's Medicare/ Medicaid Stars Program. The Stars Improvement, Clinical Professional 2 work… more
- CenterWell (North Charleston, SC)
- …for the development, implementation and management oversight of the company's Medicare/ Medicaid Stars Program. The Quality RN Professional work assignments are ... across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial performance and… more
- CenterWell (Hampton, VA)
- …for the development, implementation and management oversight of the company's Medicare/ Medicaid Stars Program. The Stars Improvement, Clinical Professional 2 work ... across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial performance and… more
- Commonwealth Care Alliance (Boston, MA)
- …Manager leads performance evaluation and improvement efforts, including reporting and data analysis, to ensure delegated entities meet contractual, regulatory, and ... full management responsibility for all performance measure components, including end-to-end data collection, evaluation, and timely dissemination of reports to both… more
- CVS Health (Columbus, OH)
- …and guidance to the health plan and external partners for the state Managed Medicaid pharmacy benefit. The Pharmacy Director reports to the Senior Lead Pharmacy ... and regulations pertaining to both pharmacy practice laws and Managed Medicaid /PBM regulations. The Pharmacy Director stays updated on changing regulations,… more
- CenterWell (Surprise, AZ)
- …and Medicare/ Medicaid provider numbers or ability to obtain DEA license and/or Medicaid and Medicare numbers. + Familiarity with HEDIS quality indicators and ... to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Join...evaluation of variable factors. Join a Team That's Redefining Senior Primary Care: Humana's Primary Care Organization is one… more
- Humana (Frankfort, KY)
- …financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and ... Provider Contracting, Network Management or Provider Relations experience + Experience working with HEDIS and/or Stars measures and programs + 1 or more years of… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …(CMS, department of health, etc) and consulting companies. * Experience leading HEDIS data collection and submissions. * Knowledge of statistical software ... a high performing team responsible for the execution and day-to-day management of data submissions for ACA Commercial, Medicare, and Medicaid risk adjustment and… more
- Evolent (Lincoln, NE)
- …analysis, and membership trend reporting. + 5+ years of experience in a senior data visualization role that required both the development and presentation ... BI dashboards and reports that provide actionable insights for internal partners and senior leadership. + Ability to contemplate data across multiple sources to… more