- Highmark Health (Dover, DE)
- …to chronic conditions, and coordination with the revenue programs, credentialing and quality improvement programs to improve STARS , value based care and achieve ... job works with appropriate departments in the areas of compliance, process improvement , medical record review and coding, and member and provider satisfaction for… more
- Humana (Columbus, OH)
- …in HEDIS & Stars specifications, processes, and schedules + Support clinical quality improvement by developing code, creating reports, and improving ... help us put health first** Humana is seeking a Senior Business Intelligence (BI) Engineer to join our world-class...that is focused on such data sets as Medicare Stars , HEDIS, clinical programs, CMS, etc. This… more
- Centene Corporation (St. Louis, MO)
- …fosters team concept with internal and external constituencies + Present results of improvement efforts and ongoing performance measures to senior management + ... perspective on workplace flexibility. **Position Purpose:** Lead and direct process improvement activities that provide more efficient and streamlined workflow. +… more
- ChenMed (Louisville, KY)
- … teams to deliver VIP service, standards of care and quality guidelines, and HEDIS/ STARS + Inspire seamless coverage of clinical staff for each other (eg, ... mission, we need the best primary care providers and clinical leaders that are seeking to fulfill purpose and...unit of our care model - the center. The Senior Medical Director (SMD) will partner with the Center… more
- CVS Health (Columbus, OH)
- …and affordable. Position Summary: Primary Responsibilities: * Responsible for clinical oversight of DSNP/MMP complex populations (Duals Special Needs/MMP* Develop ... and lead clinical strategy and objectives for the DSNP/FIDE populations, including...* Be able to effectively communicate these finding to Senior Management and staff at all levels.* Develop and… more
- UPMC (Pittsburgh, PA)
- …**Responsibilities:** + Work directly with Manager to identify opportunities for improvement with regards to Clinical /Non- Clinical functions, Infection ... for Epic Care. + Work directly with Manager to identify opportunities for improvement with regards to Clinical /Non- Clinical functions, Infection Control… more
- Martin's Point Health Care (Portland, ME)
- …is expected to lead the risk adjustment operations and strategy around improvement opportunities for clinical provider training, and medical record ... "Great Place to Work" since 2015. Position Summary The Senior Director of Risk Adjustment Operations in our Health...and monitoring mechanisms for projects. + Collaborates with the Stars Leaders to ensure appropriate integration of workstreams and… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Director Clinical Quality & Risk Management is a senior role at Emanate Health and ... a member of the leadership team. Reporting to the Vice President of Clinical Integration and Strategy, the Director will play a strong role in leadership and design… more
- Highmark Health (Pittsburgh, PA)
- …and patients. The incumbent will work collaboratively across matrixed teams with Clinical and Quality Leadership at AHN, Highmark Health, and Highmark Inc. to ... measurement and data analytics capabilities to monitor outcomes, identify areas of improvement and track progress against the enterprise goals. + Proactively work… more
- Highmark Health (Dover, DE)
- …the other members of the value-based reimbursement team, provider relations, senior markets, analytics, actuary and key internal/external stake holders to provide ... not limited to: Advising primary care practices, physicians, nurses and other clinical staff to assist them on their conversion to value-based care; Dissemination… more
- Universal Health Services (Reno, NV)
- …aligned with Prominence Health's clinical , business, quality measurement, and improvement strategies. The Senior Director will advise on best practices, ... the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The Senior Director, Performance Improvement provides strategic leadership in… more
- University of Pennsylvania (Philadelphia, PA)
- …has a 40-year track record of using health information technology to support clinical practice, quality improvement , and research, starting with the adoption of ... Philadelphia (CHOP) seeks applicants for the role of a senior physician informatics leader to oversee the ambulatory EHR...the outcomes of this work (health IT implementation, quality improvement projects, and collaboration with clinical &… more
- Molina Healthcare (AZ)
- …Arizona are being considered at this time.** **KNOWLEDGE/SKILLS/ABILITIES** The Senior Analyst, Quality Improvement (QI) Interventions/Compliance contributes to ... either or both critical Quality functions: Clinical Quality Interventions and Quality Improvement Compliance....or other key stakeholders; input from Molina employees and senior leaders, etc. + Produces reports and analyses that… more
- Ellis Medicine (Schenectady, NY)
- …+ Maintains a close working relationship with Administration, Chief of Staff and Clinical Chiefs. + Coordinates the activities and services of the Medical Staff ... St. Peter's Health Partners. + Responsibilities included medical direction of clinical departments, enhancing physician leadership and involvement in the overall… more
- Highmark Health (Pittsburgh, PA)
- …also play a key role, working as a partner to Highmark's Chief Medical and Clinical Transformation Officer (CM&CTO), in working with the C-suite teams at each of the ... optimize revenues, maintain cost effective operations, and provide continuous performance improvement . Accountable for meeting targets in areas of Risk Revenue,… more
- Centerwell (Orlando, FL)
- …and provides recommendations in operational administrative processes, initiatives, and improvement activities. Collaborates with center and clinical leadership ... Embraces, participates in, provides recommendations, and leads in operational and clinical process initiatives and improvement activities. Helps facilitate the… more
- Molina Healthcare (Albuquerque, NM)
- …contributes to either or both of these critical Quality functions: Clinical Quality Interventions and Quality Improvement Compliance. + Collaborates ... **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans, and implements new and...or other key stakeholders; input from Molina employees and senior leaders, etc. + Produces reports and analyses that… more
- Prime Therapeutics (Columbus, OH)
- …This role provides leadership and subject matter expertise on Medicare Stars , Medicaid quality and the Commercial/Health Insurance Marketplace Quality Rating System ... + Analyze clients' quality data to develop and recommend strategies for improvement and/or maintenance of quality ratings; create and manage project plans to… more
- Health First (Rockledge, FL)
- …and activities for Health First Health Plans in partnership with appropriate senior leaders. Develop and maintain care management strategic plans to support ... integrated care programs and continue optimizing as needed to achieve the desired clinical and business outcomes. 6. Ensure the Care Management team at the Health… more
- RWJBarnabas Health (Elizabeth, NJ)
- …customer requests and inquiries in a timely fashion. Makes recommendations to Senior Team regarding improvement strategies through program development Quality ... Center, an RWJBH facility is searching for a Director of Performance Improvement with supportive and empowering leadership qualities, The Director will have the… more