- 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 requirements of National Committee for Quality Assurance (NCQA) and regulatory. Applying both business knowledge...Serves as a team member for activities focused on HEDIS performance improvement + Analyzes HEDIS… more
- Centene Corporation (Columbus, OH)
- …Business Administration or Health Care Administration or equivalent experience. 3+ years of quality improvement , HEDIS project management or health care ... + Supervise the daily activities of staff to promote quality improvement and efficient methods + Assist...reports for each HEDIS measure, including evaluating improvement opportunities + Manager the coordinate … more
- Centene Corporation (Sacramento, CA)
- …Master's in Public Health or related field preferred. + 4+ years of quality improvement or project management experience in managed care with advanced ... networks to engage, recommend and support improved coding for direct impact on HEDIS data capture strategies in accordance with National Committee for Quality … more
- Centene Corporation (Columbia, SC)
- …you to reside in South Carolina **Position Purpose:** Coordinate and monitor quality improvement and organizational projects from inception to closure including ... experience. Master's in Public Health or related field preferred. 4+ years of quality improvement or project management experience in managed care with advanced… more
- CenterWell (Tampa, FL)
- …Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement + Strong knowledge of HEDIS /Stars/CMS + Excellent presentation ... Stars Improvement Clinical Professional (RN) collaborates with market leadership, and quality improvement team to develop and implement programs designed to… more
- CenterWell (Kissimmee, FL)
- …Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement + Strong knowledge of HEDIS /Stars/CMS + Excellent presentation ... Improvement Clinical Professional (RN): + Collaborates with market leadership, and quality improvement team to developand implement programs designed to… more
- BlueCross BlueShield of North Carolina (NC)
- …degree, 5+ years of experience in related field + Knowledge of DSNP clinical quality improvement operations and HEDIS **Bonus Points** + Strong analytical, ... as required to redirect activities and attain objectives. + Developing HEDIS project plans. + Cross-departmental collaboration and stakeholder education. +… more
- Molina Healthcare (OH)
- … Interventions is responsible for developing, implementing, and monitoring the success of quality improvement interventions. The Manager works to coordinate ... 3+ years' experience with member/ provider ( HEDIS ) outreach and/or quality intervention or improvement studies (development, implementation, evaluation). +… more
- Molina Healthcare (Reno, NV)
- …program management meetings, outcomes from these activities are documented, and continuous quality improvement tools are used to highlight the processes, ... **Job Description** **Job Summary** The Manager , Quality Program Management and Performance...indicators, process reviews, and gap analyses + Utilizes proven quality improvement methods, such as the Plan-Do-Study-Act… more
- LifePoint Health (Las Cruces, NM)
- …one-on-one meaningful interactions regarding current performance. Utilize professional, clinical and/or quality improvement experience and expertise to guide the ... volumes in PCP visits, colonoscopies, cervical cancer screenings, and mammograms. The Quality Practice Manager (QPM) will collaborate with employed practices to… 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 ... * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of experience supporting HEDIS engine activity, risk… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …least 3 years in Medicare Advantage products required + 7 years' experience in quality improvement and quality management activities + 5\+ years ... **Job Responsibilities** + Oversee functions performed by separate teams including quality strategy, quality vendor management and quality data management +… 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 ... results for projects that are consistent with the organization's strategic goals. The Manager , Clinical Quality Improvement will oversee the day-to-day… more
- Elevance Health (Metairie, LA)
- … quality management to direct the clinical quality initiatives, including HEDIS and CAHPS quality improvement , NCQA accreditation and compliance with ... and departmental goals. + Maintains expert knowledge of current industry standards, quality improvement activities, and strong medical management skills. +… more
- Elevance Health (Los Angeles, CA)
- …of company HEDIS performance. Implements strategies that meet clinical, quality , and network improvement goals. + Build positive working relationships ... **Title:** Behavioral Health Provider Quality Manager **Candidates must posses a...value delivered to Carelon members. Drives BH provider performance improvement year over year through education and data. This… more
- Apicha Community Health Center (New York, NY)
- …Manager collaborates with a multidisciplinary staff to meet Population Health and quality improvement goals through projects aligned with the mission of ... data is accurate and reliable for use in performance improvement efforts Quality Improvement +...and CPT coding strongly preferred + Understanding of UDS, HEDIS , and NCQA PCMH accreditation quality standards… more
- CenterWell (Covington, LA)
- …Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement + Strong knowledge of HEDIS /Stars/CMS + Excellent presentation ... Stars Improvement Clinical Professional (RN) collaborates with market leadership, and quality improvement team to develop and implement programs designed to… more
- Centene Corporation (Jefferson City, MO)
- …Plans, organizes, monitors, and oversees projects for Home State Health Plan's Quality Improvement department, utilizing cross functional teams, and various ... defined requirements and meet company strategic objectives. The Project Manager II role is primarily remote with 10% travel...in MS Office Suite + Lean Six Sigma + Quality experience in a Managed Care environment ( 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 ... Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA)/ Quality Payment Program (QPP), Medicare Advantage, CMMI projects, ACOs,… more
- Centene Corporation (Iselin, NJ)
- …years of managed care or medical group experience, provider relations, quality improvement , claims, contracting utilization management, or clinical operations. ... improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS / quality , cost and utilization, etc. + Completes special projects as assigned… more
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