- Vanguard Medical Group (Jersey City, NJ)
- …bonus and other company-sponsored benefits. Benefits include: 401(k) retirement savings plan with company match Comprehensive health insurance (medical, ... chart prep by reviewing prior notes, lab results, and specialist consults. Ensure open care gaps and outstanding quality...are identified and prepared prior to patient visits. Flag health maintenance and preventive care items for provider review.… more
- Molina Healthcare (Syracuse, NY)
- …Description** **Job Summary** The Sr Specialist , Provider Engagement role implements Health Plan provider engagement strategy to achieve positive quality and ... engagement activities. Ensures the core set of Tier 2 providers in the Health Plan have engagement plans to meet annual quality and risk adjustment goals. Drives… more
- Beth Israel Lahey Health (Westwood, MA)
- …lives.** Under the supervision of the Quality Manager, the Population Health Specialist (PHS) supports collaboration, communication and care coordination ... with all members of the health care team, including but not limited to POD...identifying key drivers of performance and implementation of project plan (s) initiatives to impact those key drivers. **Job Description:**… more
- UCLA Health (Los Angeles, CA)
- …working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan . You will: + Conduct medical record audits for physicians ... Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will...Angeles area at least three days a week. UCLA Health salary range for this title code is $92,600-202,200/annually.… more
- Centene Corporation (Topeka, KS)
- …one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national ... on workplace flexibility. **Position Purpose:** The Senior Quality Improvement Specialist is responsible for coordinating assigned regulatory, accreditation, clinical… more
- Emanate Health (Covina, CA)
- …Requirement :** Prior experience in Provider Relations within IPA or Health Plan setting is preferred. Knowledge of HEDIS , HCC, and RAF strongly preferred. ... **Current Emanate Health Employees - Please log into your Workday...company in the country. **J** **ob Summary** Physician Relations Specialist work as liaisons to healthcare providers. Responsible for… more
- Sharp HealthCare (San Diego, CA)
- …provider communications, as needed.Recommends and/or drafts provider communications relative to health plan policies and procedures.Develops a communication ... presentations.Conducts external research to identify potential providers for the Sharp Health Plan provider network.Works closely with utilization management and… more
- Molina Healthcare (Vancouver, WA)
- …initiatives including all lines of business (Medicare, Marketplace, Medicaid). Executes health plan 's member and community quality focused interventions and ... **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements...healthcare with a minimum of 2 years' experience in health plan member interventions, managed care, or… more
- Adelante (Phoenix, AZ)
- WIC Quality Assurance Specialist - Phoenix, AZ Job Details Job Location Adelante Healthcare Center Support Office - Phoenix, AZ Description POSITION SUMMARY The WIC ... Quality Assurance Specialist ensures the WIC program operates efficiently, complies with...degree + Experience in managed care with knowledge of HEDIS and STARS Quality Metrics preferred + Quality Assurance… more
- TEKsystems (Springfield, IL)
- …Reporting, PERM, T-MSIS, or similar initiatives. + 2+ years of experience with HEDIS , CHIPRA, or other healthcare quality metrics. + Excellent verbal and written ... to change and may be subject to specific elections, plan , or program terms. If eligible, the benefits available...employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee… more
- Covenant Health Inc. (Knoxville, TN)
- …needs. + Collaborates and communicates effectively with the provider and other members of the health care team to plan and implement the care of the patient in ... time and place. We're a proud member of Covenant Health ! Position Summary: The RN Care Coordinator II is...authority for providing comprehensive care coordination and knowledge to plan , implement, monitor and evaluate the outcomes of care… more
- Fallon Health (Berkshire, MA)
- **Overview** **About us:** Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in ... 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually...and care coordination, consistent with the member specific care plan developed by the NCM and Care Team. Responsibilities… more
- CenterWell (Jacksonville, FL)
- …care strategic vision and initiatives and foster stakeholder relationships, including health plan partners, healthcare providers (eg specialists, hospitals) and ... care ownership and clinical excellence in age-friendly senior primary care including health promotion & prevention, disease management, effective specialist &… more
- ERP International (Barksdale AFB, LA)
- …is seeking a **Nurse Practitioner,** for a Full-Time position supporting **Occupational Health ** at Barksdale AFB, LA. Apply online today and discover more about ... opportunity. www.erpinternational.com **Be the Best!** Join our team of exceptional health care professionals across the nation. Come discover the immense pride… more
- Dignity Health (Phoenix, AZ)
- …Network (ACN) is a clinically integrated physician network and is a Dignity Health and Abrazo Health (Tenet) physician collaboration. The Clinical Performance ... (CPL) is an employee of Arizona Care Network, doing business as Dignity Health Managed Services Organization, a physician support organization owned by Dignity … more
- Veterans Affairs, Veterans Health Administration (Palo Alto, CA)
- …and distributive pharmacy programs and services for the Veterans Affairs Palo Alto Health Care System (VAPAHCS). VAPAHCS is a major teaching tertiary care referral ... successful attainment of clinical performance measures affecting the SAIL and HEDIS measures. Ensures accountability among staff in meeting performance standards by… more
- CenterWell (Phoenix, AZ)
- …capabilities interrelate across the function or segment. As a Market CMO you will plan , organize, manage and supervise health care services offered in the ... part of our caring community and help us put health first** The Market CMO serves as a ...direction in pursuit of cost effective, quality healthcare. + Plan , organize, manage and supervise the roles of the… more
- CenterWell (Richmond, VA)
- …care ownership and clinical excellence in age-friendly senior primary care including health promotion & prevention, disease management, effective specialist & ... part of our caring community and help us put health first** The Market CMO is an instrumental clinical...collaborate in the hiring and contracting of providers. + Plan , organize, manage, and supervise the roles of the… more
- CenterWell (Daytona Beach, FL)
- …care strategic vision and initiatives and foster stakeholder relationships, including health plan partners, healthcare providers (eg specialists, hospitals) and ... care ownership and clinical excellence in age-friendly senior primary care including health promotion & prevention, disease management, effective specialist &… more
- CenterWell (Morrow, GA)
- …of doctors, advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our ... part of our caring community and help us put health first** Humana's Primary Care Organization is one of...Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. **Additional Information:** + Guaranteed base salary… more
