• Stars Senior Data Analyst

    Commonwealth Care Alliance (Boston, MA)
    **Why This Role is Important to Us:** As a Stars Senior Data Analyst , your main focus will be to improve publicly reported rates and close the gaps in Stars ... Doing:** + Knowledge of Medicare Star Rating methodology; NCQA HEDIS measures; CAHPS and HOS surveys + Intermediate to...to develop, interpret and explain analytics needed by the business for decision making and improvement. + Demonstrated ability… more
    Commonwealth Care Alliance (02/07/24)
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  • Provider Network Performance Analyst

    Medical Mutual of Ohio (Brooklyn, OH)
    …contracting regions with quality, utilization, and cost analysis. **Provider Network Performance Analyst I** + Gathers and maintains data from multiple sources and ... contracting initiatives. + Performs other duties as assigned. **Provider Network Performance Analyst II** + Conducts quality assurance analysis on data from multiple… more
    Medical Mutual of Ohio (04/25/24)
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  • Medicare Provider Performance Lead Analyst

    The Cigna Group (Houston, TX)
    …Advantage business in their market in the following aspects: Growing the MA Business The Provider Performance Lead Analyst is accountable for the growth of ... **The Provider Performance Lead Analyst is a key member of the market...Risk Adjustment in order to develop solutions for strategic business needs **_Local travel required - 30% of time_**… more
    The Cigna Group (04/27/24)
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  • Senior Clinical Quality Management Analyst

    Highmark Health (Dover, DE)
    …medical record documentation, and HCC Coding. + Conduct, collect and analyze information and data from office site and/or medical record reviews to continually ... identify gaps and communicate results. Conduct continuing education to providers on STARS, HEDIS , and HCC Coding. Conduct re-audits as needed. + Other duties as… more
    Highmark Health (02/23/24)
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  • Clinical Data Analyst III

    LA Care Health Plan (Los Angeles, CA)
    …Data Analyst (CHDA) Required Training Physical Requirements Light Additional Information Dept Specific: Health Equity: This position is located in the Health ... Clinical Data Analyst III Job Category: Clinical Department: Quality Improvement...quarterly, biannual, or annual basis. This position works with Information Systems analysts when ongoing reports can be accurately… more
    LA Care Health Plan (04/13/24)
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  • Epic Analyst

    University of Miami (Miami, FL)
    …Health System, "UHealth", IT Department has an exciting opportunity for an Epic Analyst - Healthy Planet. The Epic Analyst provides oversight and leadership ... to optimize the application's configuration, function, and access. The Epic Analyst facilitates day-to-day application support and resolving application issues and… more
    University of Miami (04/12/24)
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  • Senior Stars & Risk Adjustments Analyst

    CareFirst (Baltimore, MD)
    …into a CareFirst location periodically for meetings, training and/or other business -related activities. **ESSENTIAL FUNCTIONS:** + Develops and works with structured ... data from multiple sources such as HEDIS , CAHPS, Stars and Risk Adjustment related performance and...from multiple systems. Produces regular and adhoc report for business stakeholders to monitor and track Risk Adjustment and… more
    CareFirst (04/23/24)
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  • Business Analyst - USFHP

    Pacific Medical Centers (Seattle, WA)
    …Application (MCA) module for US Family Health Plan's managed care line of business : builds fee schedules, provider and vendor dictionary entries, and plan benefits ... + Bachelor's Degree: Related field or + Equivalent experience in Health Care Business Administration as required by URAC + Four years: Minimum of four years'… more
    Pacific Medical Centers (03/28/24)
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  • Stars Quality Analyst

    Humana (Tallahassee, FL)
    …caring community and help us put health first** The STARS Improvement Analyst develops, implements, and project management of the company's Medicare/Medicaid Stars ... all Stars quality improvement programs and initiatives. The STARS Improvement Professional 2/ Analyst + Contribute to programs designed to increase the plan quality.… more
    Humana (04/25/24)
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  • Provider Communications Specialist Sr (Hybrid)

    AmeriHealth Caritas (Manchester, NH)
    …development and maintenance, and fee schedules, etc. Interfaces with Plan's data analyst to compile, analyze, and disseminate information from provider calls, ... to improved health status of our members, achieving NCQA accreditation, HEDIS measures, etc. **Education/Experience:** + Bachelor Degree in Communications, English,… more
    AmeriHealth Caritas (04/03/24)
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