- Molina Healthcare (OH)
- …skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis, and/or ... intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions… more
- Humana (Louisville, KY)
- …health outcomes, optimized cost performance and measurable program value across Medicaid . This executive leverages advanced analytical, data science, and ... caring community and help us put health first** The Vice President, Medicaid Clinical Economics & Quality provides strategic and operational leadership for clinical… more
- Molina Healthcare (Columbus, OH)
- …corresponding tracking of progress and impact of such interventions. + Assist retrospective HEDIS rate tracking and supplemental data impact reporting. + Develop ... automated analytical as well as Reporting modules related to Quality/ HEDIS for Medicaid , Marketplace and Medicare/MMP. +...Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS… more
- Fair Haven Community Health Care (New Haven, CT)
- …(Epic/Clarity/Caboodle, eClinicalWorks, NextGen, Athena, etc.) and/or claims data ( Medicaid /Medicare/commercial). + Working knowledge of eCQMs, UDS, HEDIS , ... care, regardless of ability to pay. Job purpose The Senior Data Analyst turns clinical, operational, and...maintain dashboards and reports for clinical quality (ex. UDS, HEDIS ), operations, regulatory, revenue cycle, and VBC performance. +… more
- Humana (Gainesville, FL)
- …planning. Reviews and communicates results of programs. + Provider non-standard supplemental data trending + Provider level HEDIS in service + Develop ... visits up to 40% of the time and is not fully remote. The Senior Stars Improvement, Clinical Professional (RN) is responsible for the development, implementation and… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** Senior Healthcare Network Consultant / Senior Network Performance Professional at Humana, ... and overall performance through strategic initiatives and strong relationship-building. Senior Healthcare Network Consultant / Senior Network Performance… more
- Humana (Dunedin, FL)
- …remote with travel to provider offices within region The Quality Improvement Senior Clinical Professional (RN) is responsible for the development, implementation and ... region (Clearwater, St. Petersburg, Palm Harbor, Dunedin) The Quality Improvement Senior Clinical Professional (RN) develops programs designed to increase the plan… more
- Humana (Raleigh, NC)
- …a part of our caring community and help us put health first** As a Senior Network Performance Professional at Humana, you will play a pivotal role in enhancing ... overall performance through strategic initiatives and strong relationship-building. As a Senior Network Performance Professional at Humana, you will play a pivotal… more
- Humana (Olympia, WA)
- …a part of our caring community and help us put health first** As a Senior Network Performance Professional at Humana, you will play a pivotal role in enhancing ... as an expert on the Stars/Quality program, educating physician groups on HEDIS , patient safety, and patient experience. Collaborate to develop tailored action plans… more
- CenterWell (Phoenix, AZ)
- …financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and ... of our caring community and help us put health first** The Senior Provider Engagement Professional develops and grows positive, long-term relationships with… more
- Highmark Health (Frankfort, KY)
- …or automated model scoring. + Familiarity with call center analytics, provider engagement data , or member experience metrics (CAHPS, HEDIS , STARS). **Technical ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** The Senior Marketing Analytics Analyst plays a critical role in transforming customer, digital,… more
- Fallon Health (Boston, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... and nursing assessment skills, may complete NaviCare Program Assessment Tools and Minimum Data Set Home Care (MDS HC) Form when a member's medical/functional status… more
- Humana (Helena, MT)
- …and HEDIS quality measures. The ideal candidate has deep expertise in Stars/ HEDIS data , regulatory requirements, and agile product development, and 3 tier ... Define and maintain the vision, strategy, and roadmap for data products that enable CMS Stars and HEDIS...projects or programs + Proficiency in understanding Healthcare related data + Proficiency in verbal/written communication to senior… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization to develop sophisticated ... strategic planning, decision-making, goal setting, and effective performance measurement. The Data Science Analyst III demonstrates sound and a more advanced… more
- Datavant (Columbia, SC)
- … data for trends, disease/diagnosis prevalence and hierarchy + Experience managing data flows for chart retrieval, RA coding, HEDIS abstraction and quality ... Datavant is a data platform company and the world's leader in...+ Run various risk adjustment models for Medicare Advantage, Medicaid or ACA to forecast patient risk scores and… more
- CenterWell (Orlando, FL)
- …health + HEDIS and Stars performance + Operational improvements + Data sharing and connectivity + Documentation and coding + Additional areas related to ... for the development, implementation and management oversight of the company's Medicare/ Medicaid Stars Program. The Stars Improvement, Clinical Professional 2 work… more
- CenterWell (North Charleston, SC)
- …for the development, implementation and management oversight of the company's Medicare/ Medicaid Stars Program. The Quality RN Professional work assignments are ... across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial performance and… more
- CenterWell (Hampton, VA)
- …for the development, implementation and management oversight of the company's Medicare/ Medicaid Stars Program. The Stars Improvement, Clinical Professional 2 work ... across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial performance and… more
- Commonwealth Care Alliance (Boston, MA)
- …Manager leads performance evaluation and improvement efforts, including reporting and data analysis, to ensure delegated entities meet contractual, regulatory, and ... full management responsibility for all performance measure components, including end-to-end data collection, evaluation, and timely dissemination of reports to both… more
- CenterWell (Surprise, AZ)
- …and Medicare/ Medicaid provider numbers or ability to obtain DEA license and/or Medicaid and Medicare numbers. + Familiarity with HEDIS quality indicators and ... to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Join...evaluation of variable factors. Join a Team That's Redefining Senior Primary Care: Humana's Primary Care Organization is one… more