- Elevance Health (Nashville, TN)
- Anticipated End Date: 2025-08-04 Position Title: Clinical Quality Director - Stars/ HEDIS Job Description: Clinical Quality Director - Stars/ HEDIS Location: ... record of driving 4- to 5-Star performance through successful Stars and HEDIS gap closure initiatives, with experience spanning diverse population segments and… more
- Molina Healthcare (Long Beach, CA)
- Job Description Job Description Job Summary The Manager , Quality Program Management and Performance oversees and leads activities to maintain compliance with state ... Nursing, Public Health, Health Administration, Social Work, or related field HEDIS reporting or collection CAHPS improvement experience State QI experience Medicaid… more
- Fallon Health (Worcester, MA)
- …us on Facebook, Twitter and LinkedIn. Brief summary of purpose: The Nurse Case Manager (NCM) is an integral part on an interdisciplinary team focused on care ... NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager , Aging Service Access Point Geriatric Support Service Coordinator, contracted… more
- Elevance Health (Walnut Creek, CA)
- Anticipated End Date: 2025-08-25 Position Title: Behavioral Health Provider Quality Manager - Northern California Job Description: Title: Behavioral Health Provider ... Quality Manager Candidates must posses a licensure for the state...ensure high-quality care to members and achievement of company HEDIS performance. Implements strategies that meet clinical, quality, and… more
- UnitedHealth Group (Schaumburg, IL)
- …simply do not exist in any other organization, anywhere. The Account Manager Pharmacist / Clinical Consultant will lead and manage ongoing contract relationships ... therapy gaps for key chronic disease states, formulary compliance targets, and HEDIS and NCQA measures Provides superior clinical consultation and clinical account… more
- PacificSource (Springfield, OR)
- …develop and utilize each person's talents and strengths. The Stars Program Manager is accountable for providing strategic direction, oversight, and achievement of ... that ensures star ratings are achieved and maintained. The Stars Program Manager provides leadership, direction, and hands-on support to matrixed teams to deliver… more
- Blue Shield of California (Rancho Cordova, CA)
- …greater FEP team with mail and care management referral support. The CSC Program Manager , Senior will report to the Manager FEP Non-Clinical Operations. In this ... team on specifications around the Healthcare Effectiveness Data and Information Set ( HEDIS ) measures selected by Office of Personnel Management (OPM) and oversee in… more
- CenterWell Primary Care (North Miami Beach, FL)
- …across the following areas: Quality/clinical management and population health HEDIS and Stars performance Operational improvements Financial performance and ... in Florida 5+ years of clinical nursing experience Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement Strong knowledge of … more
- Gracelight Community Health (Los Angeles, CA)
- …The Patient Access Specialist works under the direction of the Patient Access Manager . The PAS is responsible for ensuring internal and external clients are provided ... be assigned to various patient population recall reports such as Enrollment, HEDIS and preventative measures reports. Identifies patients that may need enrollment… more
- CenterWell Primary Care (Longwood, FL)
- …in other roles based on business need Preferred Qualifications *Experience with HEDIS *Experience with Electronic Medical Records *Previous experience in a geriatric ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
- ChenMed, LLC (Hollywood, FL)
- …to exam rooms and ensures their comfort and well-bring prior to leaving. Acts as HEDIS champion for the PCP by providing visibility of HEDIS needs for scheduled ... email or fax. Performs other duties as assigned and modified at manager 's discretion. KNOWLEDGE, SKILLS AND ABILITIES: Exceptional customer service skills and… more
- Liberty Health (Wilmington, NC)
- …the healthcare industry. Join us! We are currently seeking an experienced: PROGRAM MANAGER - MEDICARE STARS Full Time, Days JOB SUMMARY: Accountable for the success ... of end-to-end Stars strategy and performance to include HOS, CAHPS, and HEDIS performance Knowing and understanding CMS regulations that govern the STAR Rating… more
- Molina Healthcare (Long Beach, CA)
- …Medicaid eligible members as well as Medication Adherence Programs for STAR, HEDIS and behavioral health medications. *Ensures that adequate staffing coverage is ... and to determine which recommended changes to drug therapy were implemented. *Assists Manager or Director in the collection and tabulation of data for reporting… more
- UHS (Riverside, CA)
- …Action plans from audits (CAPs), medical record audits, coordinate annual HEDIS Data Collection, conduct relevant QI studies, and coordinate CPPI. Review/respond ... in accordance with CMS, CDPH, and DMHC regulations and guidelines. Assist in HEDIS Data Collection and conducts Quality studies. QUALIFICATIONS: To perform this job… more
- CenterWell Primary Care (Las Vegas, NV)
- …environment Knowledge of Medicare guidelines and coverage Knowledge of HEDIS quality indicators Additional Information Guaranteed base salary + quarterly ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
- Community Health Centers of the Central Coast (Santa Maria, CA)
- Job Title: Clinical Services Supervisor, RN Department: Medical Reports To: Health Center Manager FLSA Status: Exempt Wage Range that the Company Expects to Pay: ... bi-weekly SUMMARY Under the direct supervision of the Health Center Manager and in-direct clinical supervision of Nursing Administration, the Clinical Services… 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
- 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
