- Elevance Health (Nashville, TN)
- …Clinical Quality Director is responsible for working with the regional head of health care management to direct the clinical quality initiatives, including NCQA ... the performance of direct reports. Minimum Requirements: Requires BA/BS in a clinical or health care field (ie nursing, epidemiology, health sciences) and 5… more
- Fallon Health (Worcester, MA)
- …addressing high risk members o Educate members on preventative screenings and other health care procedures such as vaccines, screenings according to established ... Manages NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager , Aging Service Access Point...continuum of care consistent with the Member's health care goals and needs o Works… 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 ... leaders passionate about transforming American healthcare delivery. The Provider Quality Manager is responsible for leading Behavioral Health (BH) provider… more
- CenterWell Primary Care (Longwood, FL)
- …of senior-focused primary care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on ... learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and… more
- Molina Healthcare (Long Beach, CA)
- …of experience in healthcare with a minimum of 2 years' experience in health plan quality management improvement, managed care , or equivalent experience ... Job Description Job Description Job Summary The Manager , Quality Program Management and Performance oversees and...QUALIFICATIONS: Advanced degree in Nursing, Public Health , Health Administration, Social Work, or related field HEDIS… more
- CenterWell Primary Care (North Miami Beach, FL)
- …of senior-focused primary care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on ... relationships across the following areas: Quality/clinical management and population health HEDIS and Stars performance Operational improvements Financial… more
- UnitedHealth Group (Schaumburg, IL)
- …looking for something bigger for your career. How about inventing the future of health care ? OptumRx is creating an innovative approach to Pharmacy Benefit ... work you do with our team will directly improve health outcomes by connecting people with the care...not exist in any other organization, anywhere. The Account Manager Pharmacist / Clinical Consultant will lead and manage… more
- PacificSource (Springfield, OR)
- …Star Rating objectives. Identify trends and areas for continuous improvement in member care and health plan performance, fostering a culture of ongoing ... help people? Join PacificSource and help our members access quality, affordable care ! PacificSource is an equal opportunity employer. All qualified applicants will… more
- Blue Shield of California (Rancho Cordova, CA)
- …system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by ... outreach and engagement calls, and supports the greater FEP team with mail and care management referral support. The CSC Program Manager , Senior will report to… more
- ChenMed, LLC (Hollywood, FL)
- …serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care . ChenMed is changing lives for the people we serve and the ... your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great...their comfort and well-bring prior to leaving. Acts as HEDIS champion for the PCP by providing visibility of… more
- Liberty Health (Wilmington, NC)
- There's no place like Liberty Health Come explore career opportunities with Liberty Health , a dynamic leader in the healthcare industry. Join us! We are ... currently seeking an experienced: PROGRAM MANAGER - MEDICARE STARS Full Time, Days JOB SUMMARY:...Stars strategy and performance to include HOS, CAHPS, and HEDIS performance Knowing and understanding CMS regulations that govern… more
- Molina Healthcare (Long Beach, CA)
- …staff of a clinical pharmacy outreach service that educates patients and their health care team to optimize medication related healthcare outcomes, ensure ... members as well as Medication Adherence Programs for STAR, HEDIS and behavioral health medications. *Ensures that... care team, including referrals to state plan health care services. *Analyzes and reviews medication… more
- CenterWell Primary Care (Las Vegas, NV)
- …of senior-focused primary care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care . Acts as an active participant and lead with the … more
- UHS (Riverside, CA)
- …Riverside Medical Clinic is the best place to work, practice medicine, and receive care . SUMMARY: Prepare Health Plan required reports, Action plans from audits ... in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory… 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: ... $3,969.00 bi-weekly SUMMARY Under the direct supervision of the Health Center Manager and in-direct clinical supervision...by provider's care plan. Coordinates with the Care Team (Primary Care Provider, Health… more
- AmeriHealth Caritas (Newtown Square, PA)
- …or Business Management + Minimum 5 years of working experience in the health care industry + Minimum 2 years of HEDIS project management and data collection ... skills Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping people… more
- Centene Corporation (Phoenix, AZ)
- … Care Administration or equivalent experience. 3+ years of quality improvement, HEDIS project management or health care related experience. Working ... functional process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities + Manager the… more
- Somatus (Mclean, VA)
- …in accordance with HEDIS technical specifications as well as Somatus and health plan specifications. + Remain updated on NCQA HEDIS Technical Specifications ... Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the...programs. + Interface with data support, quality assurance team, HEDIS Quality Manager , and IT to collect… more
- McLaren Health Care (Flint, MI)
- …forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of McLaren Health Care Corporation and is the parent company of McLaren Health ... Michigan-based health plan dedicated to meeting the health care needs of each of our...(QPIP). Manages the Healthcare Effectiveness Data and Information Set ( HEDIS ) process. Facilitates the delivery of medical care… more
- Praxis Health (Portland, OR)
- …of medical terminology and managed care . Required Experience + Population health program involvement or leadership + HEDIS metrics tracking and improvement ... and we're searching for an experienced LPN or MA Care Manager to join our advanced primary...healthcare companies in Oregon. We are not "big box" health care , but rather a company of… more
