- CVS Health (Atlanta, GA)
- …day. **A Brief Overview** Leverages technology and data to improve healthcare outcomes by designing, implementing, and maintaining health information systems, ... analyzing healthcare data, and utilizing technology to support time-series modeling,...modeling, machine learning, and MLOps practices. Applies expertise in healthcare and information technology to ensure efficient data management,… more
- Molina Healthcare (Atlanta, GA)
- **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... program and/or project management experience in risk adjustment and/or quality * 2+ years of experience supporting HEDIS...running queries in Microsoft Azure or SQL server * Healthcare experience and functional risk adjustment and/or quality… more
- Molina Healthcare (Atlanta, GA)
- …sources. + Knowledge of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of ... **Job Summary** The Manager , Medical Economics provides support and consultation to...related to cost, utilization and revenue for multiple Molina Healthcare products. Analyzes data and dashboard reports to monitor… more
- Molina Healthcare (Atlanta, GA)
- …management, strategy, and compliance + Knowledge of value based programs, risk adjustment models, quality metrics such as HEDIS and STARS, knowledge of coding + ... **JOB DESCRIPTION** **Job Summary** The Regional Manager Value Based Programs plays a critical role...annual targets for each VBP/VBC in conjunction with national quality and risk adjustment VPs, Regional Directors of … more
- Molina Healthcare (Atlanta, GA)
- … Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance ... experience in healthcare with 1 year experience in health plan quality improvement, managed care, or equivalent experience. + Demonstrated solid business writing… more
- CenterWell (Atlanta, GA)
- …to inquiries and issues. **Post-Visit/Offshore Coding Collaboration:** + Perform Quality Assurance on post-visit reviews. (Frequency and sampling methodology to ... Perform individual chart research as requested. + Collaborate with HEDIS leaders and champions to identify HEDIS ...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- CenterWell (Atlanta, GA)
- …to obtain DEA license and/or Medicaid and Medicare numbers + Familiarity with HEDIS quality indicators and Medicare guidelines. **Compensation & Benefits** + ... behavioral health specialists, and more-all working together to deliver personalized, high- quality care. We're not just improving healthcare -we're improving… more
- Elevance Health (Atlanta, GA)
- …Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction. Provides ... existing models to create predictive impact decision making tools; performing healthcare cost analysis to identify strategies to control costs; projecting cost… more
- CenterWell (Atlanta, GA)
- …with clinicians to achieve optimal patient outcomes and company initiatives, including Quality , HEDIS /STARs, AHCA, financial management, and employee and patient ... us put health first** The Center Administration is a healthcare professional who leads the daily operations of our...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- CenterWell (Smyrna, GA)
- …Knowledge of Medicare guidelines and coverage + Bilingual is a plus + Knowledge of HEDIS quality indicators + Guaranteed base salary + biannual bonus + Excellent ... We are a value based care provider focused on quality of care for the patients we serve. Our...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- CenterWell (Marietta, GA)
- …environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. **Additional Information:** + Guaranteed base salary + ... We are a value based care provider focused on quality of care for the patients we serve. Our...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- CenterWell (Atlanta, GA)
- …environment . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality indicators **Additional Information:** . Total compensation package ... We are a value based care provider focused on quality of care for the patients we serve. Our...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- CenterWell (Atlanta, GA)
- …relationship environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding ... / disease + prevalence / appropriate levels of clinical quality care + Providing guidance to individual clinicians about...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- Elevance Health (Atlanta, GA)
- …committed clinicians and business leaders passionate about transforming American healthcare delivery. **Build the Possibilities. Make an Extraordinary Impact.** ... + Assess current practice patterns, assets, and challenges utilizing NCQA Standards, HEDIS audits, site reviews, and medical records reviews. + In partnership with… more
- Elevance Health (Atlanta, GA)
- …members on medication adherence-related topics to align closely with STARs Ratings and HEDIS quality measures. + Assists members with scheduling their preventive ... dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- CenterWell (Marietta, GA)
- …assignments. Works within defined parameters to identify work expectations and quality standards, but has latitude over prioritization/timing, and works under ... years MA experience * Value Based Care experience including knowledge of HEDIS , CPT/ICD coding, and CAHPS/HOS Patient Experience. * Bilingual proficiency in English… more