- Insight Global (Minnetonka, MN)
- …York, Oregon 1 or more years of experience in HEDIS /Star programs, preferably in a clinical quality consultant role 2 or more years of Call Center or ... Job Description The Clinical Performance Quality (CPQ) Clinical...telephonic and digital engagement strategies designed to close Medicare STARS/ HEDIS gaps in care, including medication adherence, care for… more
- Highmark Health (Charleston, WV)
- …and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess the needs of each individual ... or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for collaborative work with other functions… more
- The Cigna Group (Bloomfield, CT)
- …development across clinical roles + Collaborate with leadership to influence clinical quality measures, HEDIS outcomes and continuous improvement ... and customer satisfaction, compliance, quality of care, HEDIS outcomes, and utilization metrics. + Supports Clinical...performance, innovation and patient centricity. + Serves as a clinical consultant and subject matter expert for… more
- Humana (Oviedo, FL)
- …to drive results within a provider network and MSO as it relates to clinical HEDIS measures. + Experience in preparing and delivering training sessions, ... and help us put health first** The Nurse Senior Stars Improvement, Clinical Professional/ Consultant contributes to the development, implementation, and… more
- CVS Health (Oklahoma City, OK)
- …And we do it all with heart, each and every day. **Position Summary** The Quality Management, Nurse Consultant has a key role in developing and implementing ... data-driven strategies/interventions that support the delivery of high quality health benefits and services for members. The QM Consultant coordinates, prepares… more
- CVS Health (Austin, TX)
- …barriers including health disparity and health related social needs, to improve clinical quality , promote best member and provider experience, and ensure ... all with heart, each and every day. **Position Summary** Applies specialized clinical and industry knowledge and performance improvement best practices to quality… more
- CVS Health (Springfield, IL)
- …member program - Clinical license required **Preferred Qualifications** - 2 years HEDIS experience - MBA or masters degree in healthcare or finance related field ... Summary** This role is responsible for managing partnerships with Aetna-Illinois quality vendors and community-based organizations, with the primary focus to improve… more
- ChenMed (Houston, TX)
- …overall clinical value while engaging physicians to improve clinical quality , efficiency, outcomes, cost effectiveness, and physician/patient satisfaction. ... days), CG CAHPS and net promoter score (patient experience), HEDIS and clinical gaps closures, and medical...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other… more
- LA Care Health Plan (Los Angeles, CA)
- …Minimum of 4 years of Health Services Domain experience required. 3 years of Clinical Care and 3 years of HIE, HEDIS experience preferred. Functional knowledge ... the right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …require peer-to-peer discussions with providers regarding UM case review determinations. + Provides clinical expertise on ARD cases, Quality of Care cases, ... Level I Accountabilities) + Leads, develops, directs and implements clinical and non- clinical activities that impact health care quality cost and outcomes. +… more
- Covenant Health Inc. (Knoxville, TN)
- …the patient care setting, coordinating education of staff and patients and serving as a clinical resource and consultant to the health care team. The RN Care ... through the collaborative development of practice guidelines and clinical pathways that support quality improvement activities....care. + Stays abreast of most recent changes in quality related to HEDIS measures, CMS Conditions… more
- ChenMed (Warren, MI)
- …overall clinical value while engaging physicians to improve clinical quality , efficiency, outcomes, cost effectiveness, and physician/patient satisfaction. ... days), CG CAHPS and net promoter score (patient experience), HEDIS and clinical gaps closures, and medical...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other… more
- ChenMed (Richmond, VA)
- …count for 2 slots, follow-up patients, typical 1.0 PCP FTE slots are 18-21), HEDIS >4, CG CAHPS (patient experience), clinical gaps closures, and medical cost ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other… more
- CenterWell (Atlanta, GA)
- …around clinical protocols / disease + prevalence / appropriate levels of clinical quality care + Providing guidance to individual clinicians about patient ... from patients + Ongoing chart review / audit of clinical staff to ensure quality care and...Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of… more
- ERP International (Barksdale AFB, LA)
- …care through a continuum facilitating the achievement of optimal outcomes in clinical , quality and cost-effectiveness arenas. Provides direct clinical ... most cases a referral to the Internal Behavioral Health Consultant (IBHC) in Primary Care is appropriate for an...to change. Possesses knowledge of disease management programs and clinical practice guidelines (eg VA/DoD CPGs), and HEDIS… more
- CenterWell (Phoenix, AZ)
- …relationship environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding ... and provide medical direction in pursuit of cost effective, quality healthcare. + Plan, organize, manage and supervise the...in the state of desired employment + Experience leading clinical practice operations + Demonstrate a high level of… more
- Veterans Affairs, Veterans Health Administration (Kenosha, WI)
- …CBOC, or for McHenry CBOC, the s/he has delegated authority from the Clinical Director for Primary Care (DPC) with responsibility for their respective clinic(s), and ... MAJOR DUTIES AND RESPONSIBILITIES: - Responsible for own panel of patients. Clinical / Administrative FTEE allocation will be determined by policy. - Responsible for… more
Related Job Searches:
Clinical,
Clinical Quality,
Clinical Quality Consultant,
Consultant,
HEDIS,
Quality,
Quality Consultant