- 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
- 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
- CVS Health (Chicago, IL)
- …compliance within our network responsibilities as provided within the state Medicaid contractual requirements. This position holds a variety of functions for ... streamline, policies, procedures, provider interactions/trainings and optimize workflows. + Data & Insights Utilization: Leverage analytics to identify trends,… 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 (Stuart, FL)
- …caring community and help us put health first** The Quality Improvement Senior Clinical Professional (RN) is responsible for the development, implementation and ... Beach, Stuart, Jupiter - Treasure Coast/Palm Beach Market). The Quality Improvement Senior Clinical Professional (RN) develops programs designed to increase the plan… more
- Molina Healthcare (NY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... creating tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex analyses of… more
- Humana (Richmond, VA)
- …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 ... and monitor performance toward these goals + Actively monitors and analyzes provider performance data to identify areas for improvement + Serves as an expert on the… more
- Fallon Health (Foxborough, 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
- Molina Healthcare (Chicago, IL)
- …**Preferred Experience** + 1 year of experience in Medicare and in Medicaid . + Experience with data reporting, analysis and/or interpretation. **Preferred ... programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities;… more
- Humana (Bismarck, ND)
- …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
- CenterWell (Kissimmee, 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
- Molina Healthcare (Savannah, GA)
- …programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities; ... (QI) leader within the organization enterprise wide. This position advises senior management, other corporate departments, and Molina health plans on Quality… 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
- Humana (Richmond, VA)
- …financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and ... more years of demonstrated project management experience and partnering with senior leadership on strategic initiatives + Proven planning, preparation and presenting… more
- Public Consulting Group (Jefferson City, MO)
- …more, visit www.publicconsultinggroup.com . Summary: We are seeking a senior -level, detail-oriented and self-motivated Medicaid Waiver Evaluation Consultant ... and interpreting results of quality measures, supporting strategic initiatives through data -driven insights. This role requires a strong background in data… 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
- CVS Health (Frankfort, KY)
- …and guidance to the health plan and external partners for the state Managed Medicaid pharmacy benefit. The Pharmacy Director reports to the Senior Lead Pharmacy ... and operational aspects of pharmacy and prescription drug services within the Kentucky Medicaid health plan and to execute the Pharmacy Benefit in accordance with… more
- Humana (Montgomery, AL)
- …financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and ... + Minimum of 1 year of experience working with provider groups on HEDIS and/or Stars performance improvement + Proficiency in analyzing and interpreting financial… more
