- Molina Healthcare (Columbus, OH)
- …standards as well. Lead Overreader mentors and trains new team members. Leads special HEDIS / Quality projects. **We are seeking strong experience in HEDIS ... Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS...HEDIS review and results. + Works with the Manager to monitor accuracy of abstracted records as required… more
- LA Care Health Plan (Los Angeles, CA)
- HEDIS Abstractor II (Temporary) Job Category: Clinical Department: Quality Performance Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... understand the medical record requests. Speaks with the office staff/ manager /provider to clarify the medical record request as necessary....Required: A minimum of 3 years of experience in HEDIS abstraction and/or other Quality Improvement, … more
- VNS Health (Manhattan, NY)
- …primary clinical liaison for IPAs and provider networks, ensuring alignment with STARS, HEDIS , and clinical quality objectives. + Works closely with IPAs ... including the monitoring of provider and IPA performance to drive improvements in clinical quality and outcomes. + Conducts provider education and training… more
- CenterWell (Dallas, TX)
- …the scope of provider relationships across the following areas: + Quality / clinical management and population health + HEDIS and Stars performance + ... help us put health first** **Job Profile Summary** The Manager , Stars Improvement, Clinical responsible for the...(RN) without restriction in Florida + 5+ years of clinical nursing experience + Strong knowledge of HEDIS… more
- Molina Healthcare (Columbus, OH)
- …programs/processes and member/provider outreach initiatives. + Supports provision of high- quality clinical care and services by facilitating/building strategic ... accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is responsible… more
- Healthfirst (NY)
- …& Responsibilities:** + Interacts with hospitals, providers, and members to improve quality of care, monitor progress, and recommend changes + Reviews billing codes, ... + Assists in writing member and/or provider articles on HEDIS , QARR, Medicare Advantage, and/or health promotions for the...Qualifications:** + Bachelors Degree from an accredited institution + Clinical license: LPN, RN, LMSW or LCSW + Multiple… more
- Dignity Health (Bakersfield, CA)
- …at a system/national level in the population health space. **Position Summary:** The Manager , Clinical Quality Improvement, is responsible for leading ... that are consistent with the organization's strategic goals. The Manager , Clinical Quality Improvement will...oversight/supervision/management/leadership of clinical and non- clinical quality management staff. - 3 years HEDIS … more
- Centene Corporation (Jefferson City, MO)
- …+ Oversee quality improvement related activities and staff to improve clinical quality performance measures + Analyze data to develop intervention strategies ... their home **Position Purpose:** Oversee and manage the functions of the quality improvement program from inception to closure, including National Committee for … more
- ChenMed (North Miami Beach, FL)
- …with the development and execution of business strategies that increase revenue and quality ratings ( HEDIS /STARS/ Clinical Gaps) and support our core model. ... need great people to join our team. The Center Clinical Manager (CCM) is an active leadership...operations, which may include but is not limited to: clinical quality , compliance, human resources, patient experience… more
- CenterWell (Miami Beach, FL)
- …the scope of provider relationships across the following areas: + Quality / clinical management and population health + HEDIS and Stars performance + ... without restriction in applicable state + 5+ years of clinical nursing experience + Strong knowledge of HEDIS...attention to detail with a focus on process and quality + Comprehensive knowledge of Microsoft Office applications **Preferred… more
- Elevance Health (Seven Fields, PA)
- **JR150201 Behavioral Health Clinical Quality Auditor Analyst Sr** The Behavioral Health Clinical Quality Audit Analyst Sr is a professional-level ... annual and ad hoc medical record reviews such as HEDIS and CPG compliance. + Conducts quality ...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- LifePoint Health (Las Cruces, NM)
- …volumes in PCP visits, colonoscopies, cervical cancer screenings, and mammograms. The Quality Practice Manager (QPM) will collaborate with employed practices to ... initiate one-on-one meaningful interactions regarding current performance. Utilize professional, clinical and/or quality improvement experience and expertise to… more
- Centene Corporation (Raleigh, NC)
- …workplace flexibility. **Position Purpose:** Develop Performance Improvement projects to improve clinical quality and performance measure outcomes. + Must reside ... degree in Business, related field or equivalent experience. 3+ years of related quality improvement, HEDIS and/or NCQA experience. Pay Range: $55,100.00 -… more
- Elevance Health (Cerritos, CA)
- …departments to ensure high- quality care to members and achievement of company HEDIS performance. Implements strategies that meet clinical , quality , and ... **Title:** Provider Quality Manager **Location:** Candidates must live...engages with BH providers and ensures measurable improvements in clinical and quality outcomes for members. +… more
- Elevance Health (Louisville, KY)
- … data related to pharmaceuticals to assist contracted providers in achieving cost and quality goals. + Serves as a clinical resource to other pharmacists and ... programs for contracted provider groups formulary management, achieving quality and cost goals. **How you will make an... by staying up to date on STAR and HEDIS measures. + Provider education to support clinical… more
- CenterWell (Columbus, OH)
- …required pharmacy or clinical management systems + Support CMS Stars and HEDIS quality measures for successful clinic performance + Maintain accurate and ... and help us put health first** We are seeking an ambitious and goal-oriented Clinical Pharmacist with over 5 years of experience to join our primary care… more
- ChenMed (Columbus, OH)
- …indicators. + Fosters growth and effectiveness of Pharmacy work teams to meet quality and clinical care standards/ + Assists Pharmacy leadership in ensuring ... we need great people to join our team. The Clinical Pharmacist specializing in Population Health is a skilled...specialty practice, as well as Part D education for HEDIS measures. + Acts as the pharmacy department's representative… more
- CenterWell (Covington, LA)
- …the scope of provider relationships across the following areas: + Quality / clinical management and population health + HEDIS and Stars performance + ... caring community and help us put health first** The Quality RN Professional/Stars Improvement, Clinical Professional 2... nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare quality… more
- CenterWell (Miami, FL)
- …the scope of provider relationships across the following areas: + Quality / clinical management and population health + HEDIS and Stars performance + ... and help us put health first** The Stars Improvement, Clinical Professional (RN) is responsible for the development, implementation... nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare quality… more
- Elevance Health (Woodbridge, NJ)
- …for working with the regional head of quality management to direct the clinical quality initiatives, including HEDIS and CAHPS quality improvement, ... driving the development, coordination, communication, and implementation of a strategic clinical quality management and improvement program within assigned… more
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