- MVP Health Care (Rochester, NY)
- …a healthier future for everyone - which requires innovative thinking and continuous improvement . To achieve this, we're looking for a Medical Director , ... years must be in a clinical setting). Previous experience as a medical director in a managed care/health plan is desirable. Individuals must understand various… more
- Elevance Health (Woburn, MA)
- ** Director Quality Management/ Improvement ** This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while ... an accommodation is granted as required by law._ The ** Director Quality Management/ Improvement ** is responsible for developing,...the contract related to Quality. + Leads Quality Measure Improvement Plan including HEDIS , Health Equity and… more
- Sharp HealthCare (San Diego, CA)
- …conjunction with the Director of PHM/ Medical Management and Quality Improvement Director . + Oversees and mentors Medical Directors and Physician Reviewers. ... programs and work plans. + Assists the Chief Medical Officer and the Quality Improvement Director in creating and maintaining a system that gives feedback to… more
- AmeriHealth Caritas (Washington, DC)
- …areas, other lines of business, and external vendors to identify opportunities for process improvement to drive compliance and efficiency. + Develops and ... developing, and implementing Health Plan activities related to the HEDIS process , improving HEDIS rates...and flexibility to a rapidly moving business environment. + Process improvement and project management experience. +… more
- Martin's Point Health Care (Portland, ME)
- …leadership in, or focused activity of, a Health Plan (preferred) + Knowledge of process improvement tools + Experience in Health Plan utilization management + ... Place to Work" since 2015. Position Summary The Medical Director (MD) provides clinical leadership and direction to the...MLR , inpatient days/1000, SNF days/1000, and clinical quality improvement (QI) objectives, including HEDIS and how… more
- HCA Healthcare (Campbell, CA)
- …nature of Quality and Risk Adjustment programs + Recommend areas of process improvement and best-practice medical office/physician workflows utilizing EMR and ... HCA Healthcare colleagues invested over 156,000 hours impacting our communities. As a Director of Quality and Risk Adjustment with HCA Healthcare, you can be a… more
- Sharp HealthCare (San Diego, CA)
- …and Chief Medical Officer and reports findings in conjunction with the Quality Improvement Manager. + Participates in the grievance process with the Chief ... in short and long range program planning, total quality management (quality improvement ), and external relationships. Works with all departments of Health Services… more
- Molina Healthcare (Albuquerque, NM)
- … activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, ... necessity. + Participates in and maintains the integrity of the appeals process , both internally and externally. Responsible for the investigation of adverse… more
- Molina Healthcare (Lincoln, NE)
- … activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, ... necessity. + Participates in and maintains the integrity of the appeals process , both internally and externally. Responsible for the investigation of adverse… more
- MVP Health Care (Rochester, NY)
- …a healthier future for everyone - which requires innovative thinking and continuous improvement . To achieve this, we're looking for a **Medical Director , ... in a clinical setting). Previous experience as a medical director in a managed care/health plan is desirable. +...+ Knowledge of and experience with NCQA requirements and HEDIS reporting is desirable. + Strong organizational, communication, and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical Services area ... medical policies, guidelines and medical criteria. + Assists with training medical director colleagues and nursing staff , including leadership of teaching grand… more
- CenterWell (Woodstock, GA)
- …caring community and help us put health first** The Associate Operations Director (AOD) leads Senior Focused Primary Care clinical operations in a multi-physician ... achieve optimal patient outcomes and company initiatives, including Quality, HEDIS /STARs, AHCA, optimal patient scheduling, financial management, patient engagement,… more
- Sanford Health (Sioux Falls, SD)
- …ability to clarify performance targets and objectives to drive project and process improvement strategies. Knowledge of human resources and personnel management ... satisfaction, and administrative outcome indicators for quality and continuous improvement . Responsible for providing professional, technical, and clinical expertise.… more
- Banner Health (Phoenix, AZ)
- …analytics functions within Banner Plans and Networks (BPN) including the process for designing structured data outputs such as dashboards, scorecards and ... participation on the BPN Executive Team meetings, to identify performance improvement opportunities and drive innovation in analytics supporting value-based care… more
- The Cigna Group (Bloomfield, CT)
- …roles + Collaborate with leadership to influence clinical quality measures, HEDIS outcomes and continuous improvement initiatives **Clinical Leadership & ... positively influence clinical quality measures and outcomes that result in continual quality improvement . + Collaborate with the Director of Population Health to… more
- Adelante (Phoenix, AZ)
- …position will work closely with WIC training Coordinator and WIC operations to implement process improvement and monitor process improvement changes. ... Director of WIC to identify opportunities for quality improvement and oversee performance improvement initiatives. This...degree + Experience in managed care with knowledge of HEDIS and STARS Quality Metrics preferred + Quality Assurance… more
- Trinity Health (Boise, ID)
- …hire. + Electronic health record (EHR) experience required. + Experience with process improvement or Lean philosophy preferred. **Highlights and Benefits** When ... and the highest quality of care. The Quality Performance Improvement , Population Health Team is now hiring for a...initiatives (Gaps In Care Closure) focused on Quality measures ( HEDIS ). + This position will be primarily located at… more
- Trinity Health (Boise, ID)
- …+ Competency in multiple areas preferred, including group facilitation and leadership, process improvement methodologies as above, adult education and knowledge ... Quality and Safety Plan as delegated by the SAMG Director of Quality. The position serves as a mentor...data analysis, preferably in health care. + **Experience with HEDIS (Healthcare Effectiveness Data and Information Set), PQRS (Physician… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Accountabilities) + Handles all member clinical condition management programs. + Offers process improvement suggestions and participates in the solutions of more ... procedures per corporate and departmental policy. + Implements the Case Management Process per department policies, procedures and guidelines. The process … more
- Veterans Affairs, Veterans Health Administration (Kenosha, WI)
- …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 in ... congressional inquiries, staff complaints or conflict, interdepartmental conflict, and process issues. - Responsible for innovative methods to optimize collaboration… more
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