- 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 (Columbus, OH)
- …functional process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities + Manager the ... workplace flexibility. **Position Purpose:** Supervise and coordinate team ensure HEDIS data accuracy and reporting, including investigations, auditing, and… more
- Centene Corporation (Austin, TX)
- …flexibility. **Position Purpose:** Responsible for analytical data needs for Mississippi HEDIS and Medicare stars reporting. Handle complex data requests, reports, ... claims, provider, and member data, IRS, CMS, HHSC, and HEDIS reporting. + Internal data cleansing and data reconciliation...and timelines effectively and communicate risks and issues to manager regularly + Assist with training lower level Data… more
- Centene Corporation (Sacramento, CA)
- …to engage, recommend and support improved coding for direct impact on HEDIS data capture strategies in accordance with National Committee for Quality Assurance ... (NCQA) and Healthcare Effectiveness Data and Information Set ( HEDIS ) standards and specifications. Provide insight and make recommendations to internal stakeholders… more
- Centene Corporation (Columbia, SC)
- …Quality Assurance (NCQA) and Healthcare Effectiveness Data and Information Set ( HEDIS ) preparation. + Provide functional and technical knowledge for NCQA/ HEDIS ... constituents as needed. + Coordinate Work Plan, team and resources for HEDIS /Consumer Assessment of Healthcare Providers and Systems (CAHPS) submission to Connector… more
- BlueCross BlueShield of North Carolina (NC)
- …as required to redirect activities and attain objectives. + Developing HEDIS project plans. + Cross-departmental collaboration and stakeholder education. + ... Responsible for DSNP HEDIS program management which includes HEDIS Roadmap, production runs, admin refresh, reporting, etc. + Perform compliance related… more
- LA Care Health Plan (Los Angeles, CA)
- Technical Applications Manager II Job Category: Information Technology Department: IT Solutions Delivery Location: Los Angeles, CA, US, 90017 Position Type: Full ... to achieve that purpose. Job Summary The Technical Application Manager II reports to the Senior Manager ...years of Clinical Care and 3 years of HIE, HEDIS experience preferred. Functional knowledge of HEDIS ,… more
- HCA Healthcare (Nashville, TN)
- **Description** **Job Summary and Qualifications** The Value-Based Care (VBC) Program Manager is responsible for developing and maintaining detailed technical and ... and performance improvement in the ambulatory healthcare space. The VBC Program Manager additionally serves as the Physician Services liaison to our Clinically… more
- Molina Healthcare (OH)
- …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is responsible for developing, ... implementing, and monitoring the success of quality improvement interventions. The Manager works to coordinate resources and training within the health plan and… more
- Apicha Community Health Center (New York, NY)
- …for underserved and vulnerable populations. Position Summary The Population Health Manager collaborates with a multidisciplinary staff to meet Population Health and ... the mission of Apicha and its strategic goals. The Population Health Manager supports the implementation of strategies to drive clinical transformation toward… more
- CenterWell (Arlington, TX)
- …CenterWell is a subsidiary of Humana, seeking a Primary Care Clinic Manager , that develops and leads implementation for staffing plans, policies and procedures ... patient outcomes and company initiatives including but not limited to Quality, HEDIS / STARs, AHCA, financial management and employee and patient retention. Must… more
- LifePoint Health (Las Cruces, NM)
- …visits, colonoscopies, cervical cancer screenings, and mammograms. The Quality Practice Manager (QPM) will collaborate with employed practices to achieve local ... The QPM establishes and maintains practice/provider relationships, presenting, practices HEDIS , STARS, and RAF training and planning, and contract performance… more
- Molina Healthcare (Reno, NV)
- **Job Description** **Job Summary** The Manager , Quality Program Management and Performance oversees and leads activities to maintain compliance with state ... Health, Health Administration, Social Work, or related field + HEDIS reporting or collection + CAHPS improvement experience +...(RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
- Molina Healthcare (Akron, OH)
- **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success. * Partner with other teams to ensure data quality… more
- Praxis Health (Eugene, OR)
- …healthcare clinic, and we're searching for an experienced LPN or MA Care Manager to join our advanced primary care team. This is a high-impact, in-house ... + Coordinate with centralized PXH/Regence teams to drive performance in: + HEDIS metric tracking + Transitional Care Management (TCM) + Annual Wellness Visit… more
- Centene Corporation (Iselin, NJ)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …+ Develop strategy of multiple functional teams focused on improving clinically oriented HEDIS and HOS scores as well as customer satisfaction oriented CAHPS survey ... and meet timelines effectively + Must understand Supplemental Data Collection including HEDIS , Lab, Vision, and Pharmacy as it relates to Medicare Advantage products… more
- Highmark Health (Latham, NY)
- …policies and procedures while increasing provider efficiencies and maximizing quality (STAR/ HEDIS ). The incumbent may participate as a regional representative on key ... educating providers on initiatives focused on managing medical expenses and maximizing HEDIS and STAR metrics in collaboration with internal resources. **General… more
- Centene Corporation (Queens, NY)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
- Centene Corporation (Orlando, FL)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization. **Drivers License required** Pay Range: $55,100.00 -… more
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