• Sr . Provider Engagement Account…

    Centene Corporation (Tampa, FL)
    …performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Present detailed HBR analysis and ... relations, quality improvement, claims, contracting, utilization management, or clinical operations. Project management experience at a medical group, IPA, or health… more
    Centene Corporation (05/08/25)
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  • Sr . Specialist, Member & Community…

    Molina Healthcare (Dallas, TX)
    **Job Description** **Job Summary** The Sr Specialist, Member & Community Interventions oversees and implements new and existing clinical quality member intervention ... Duties** + Acts as a lead specialist to provide project , program, and/or initiative related direction and guidance for...to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may… more
    Molina Healthcare (06/19/25)
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  • Behavioral Health Clinical Quality Audit Analyst…

    Elevance Health (Seven Fields, PA)
    **JR152864 Behavioral Health Clinical Quality Audit Analyst Sr ** This role is primarily focused on conducting medical record reviews of facilities and clinics in our ... quarterly, annual and ad hoc medical record reviews such as ASAM monitoring, HEDIS and Clinical Practice Guideline (CPG) compliance. + Coordinates site visit dates… more
    Elevance Health (06/17/25)
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  • Senior Wellness Program Manager

    Medical Mutual of Ohio (Brooklyn, OH)
    …preferred. . 5 years progressive experience as a Wellness Program Manager or equivalent experience developing and implementing wellness programs and interventions ... Exercise Physiologist preferred. . Certified Health Education Specialist (CHES), Project Management Professional (PMP) or Certified Professional in Healthcare… more
    Medical Mutual of Ohio (06/12/25)
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  • Technical Applications Manager II

    LA Care Health Plan (Los Angeles, CA)
    …purpose. Job Summary The Technical Application Manager II reports to the Senior Manager Information Technology IT Solutions Delivery. This role acts as the ... Technical Applications Manager II Job Category: Information Technology Department: IT...Act as liaison between IT Solution Delivery team and Program/ Project Managers for all Enterprise Initiatives. Manage and prioritize… more
    LA Care Health Plan (06/10/25)
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  • Manager , Health Plan Quality Interventions…

    Molina Healthcare (OH)
    …and leads the interventions Joint Operations Committee representing the Molina Plan Senior Leadership Team. In all activities, the Manager works with ... accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is responsible for developing,… more
    Molina Healthcare (06/15/25)
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  • Public Health Educator/Health Promotion…

    ERP International (Camp Pendleton, CA)
    …and strengthen the awareness of available electronic resources. * Collaborate with PHP Project Manager / Senior Strategist to construct an annual strategic ... beneficiaries. Including, but not limited to, all command specific HEDIS metrics. * Track metrics of success as informed...posters, flyers, and social media. * Collaborate with PHP Project Manager / Senior Strategist to periodically… more
    ERP International (05/21/25)
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  • Nurse Practitioner - Alpharetta

    CenterWell (Roswell, GA)
    …Must have an active/unrestricted state license, DEA license, and board certification. + Senior patient care experience. + Active BLS through the AHA (American Heart ... Strong technical experience. + 2 or more years of project leadership experience. + This role is considered patient...role is considered patient facing and is part of Humana/ Senior Bridge's Tuberculosis (TB) screening program. If selected for… more
    CenterWell (06/03/25)
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  • Primary Care Physician

    CenterWell (Corpus Christi, TX)
    …Care Organization (PCO) is the largest and fastest growing value-based care, senior -focused primary care network in the country. The Primary Care Physician (PCP) ... on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude… more
    CenterWell (06/03/25)
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  • Primary Care Physician

    CenterWell (Grand Prairie, TX)
    …Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating 340 centers across fifteen ... care team supporting patient's physical, emotional, and social wellness. At CenterWell Senior Primary Care, we want to help those in the communities we… more
    CenterWell (05/16/25)
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  • Primary Care Physician

    CenterWell (Port Orange, FL)
    …on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude ... coverage . Bilingual is a plus . Knowledge of HEDIS quality indicators **Additional Information:** . Guaranteed base salary...insurance and many other opportunities. **About Us** About Conviva Senior Primary Care: Conviva Senior Primary Care… more
    CenterWell (05/24/25)
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  • Primary Care Physician

    CenterWell (Callahan, FL)
    …on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude ... (English and Spanish) is a plus . Knowledge of HEDIS quality indicators **Additional Information:** . Time with your...insurance and many other opportunities. **About Us** About Conviva Senior Primary Care: Conviva Senior Primary Care… more
    CenterWell (05/15/25)
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  • Provider Engagement Executive

    CenterWell (Richmond, VA)
    …management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as ... of all Microsoft Office applications + Advanced organizational skills and/or project management + Ability to travel as needed **Preferred Qualifications** +… more
    CenterWell (06/05/25)
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  • Learning Facilitation Professional - Certified…

    CenterWell (Orlando, FL)
    …+ Proficiency in Microsoft Office applications including Outlook, PowerPoint, Excel, Microsoft Project + This role is considered patient facing and is part of ... + Value Based Care / Managed Care experience including knowledge of HEDIS , CPT/ICD coding, and CAHPS/HOS Patient Experience **Preferred Qualifications** + Experience… more
    CenterWell (05/23/25)
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  • Primary Care Physician

    CenterWell (Groves, TX)
    …on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude ... environment . Knowledge of Medicare guidelines and coverage. Knowledge of HEDIS quality indicators Additional Information:. Excellent benefit package - health… more
    CenterWell (05/10/25)
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