• Clinical Quality Director - Stars/…

    Elevance Health (Atlanta, GA)
    ** Clinical Quality Director** **- Stars/ HEDIS ** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and ... and quality of life through home-care and community based services. The ** Clinical Quality Director** is responsible for working with the regional head of… more
    Elevance Health (07/18/25)
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  • Lead Abstractor, HEDIS / Quality

    Molina Healthcare (Augusta, GA)
    …National Over read team, National Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. + Mentor ... **C** **E/KNOWLEDGE, SKILLS & ABILITIES:** + 5 years experience in healthcare Quality / HEDIS specific to medical record review and abstraction + Intermediate… more
    Molina Healthcare (07/17/25)
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  • HEDIS Program Manager

    CVS Health (Atlanta, GA)
    …annual HEDIS project plans in alignment with QAPI and Quality /Population Health program strategies. Establishes and maintains timelines for delivery of assigned ... projects. + Supports healthcare quality efforts by conducting data analysis on HEDIS...and delivers education and training programs to enhance the clinical knowledge and skills of healthcare providers and staff.… more
    CVS Health (08/01/25)
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  • Senior Integrated Clinical Pharmacist…

    CenterWell (Atlanta, GA)
    …required pharmacy or clinical management systems + Support CMS Stars and HEDIS quality measures for successful clinic performance + Maintain accurate and ... and help us put health first** We are seeking an ambitious and goal-oriented Clinical Pharmacist with over 5 years of experience to join our primary care… more
    CenterWell (07/26/25)
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  • Provider Engagement Account Manager

    Centene Corporation (Atlanta, GA)
    …performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS / quality , cost and utilization, etc. + Completes special projects as ... at a medical group, IPA, or health plan setting. Proficient in HEDIS / Quality measures, cost (MLR) and utilization. Account management experience strongly… more
    Centene Corporation (07/20/25)
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  • Primary Care Physician Lead

    CenterWell (Savannah, GA)
    …around clinical protocols / disease + prevalence / appropriate levels of clinical quality care + Providing guidance to individual clinicians about patient ... from patients + Ongoing chart review / audit of clinical staff to ensure quality care and...Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of… more
    CenterWell (06/27/25)
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  • Center Administrator

    CenterWell (Savannah, GA)
    …with clinicians to achieve optimal patient outcomes and company initiatives, including Quality , HEDIS /STARs, AHCA, financial management, and employee and patient ... Management: * Oversee operations within a multi-physician office or clinical group, maintaining an owner-operator mindset and leading by example,… more
    CenterWell (06/10/25)
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  • Pharmacist, Utilization Management (UM)

    Molina Healthcare (Augusta, GA)
    …and appeals process. + Contributes to projects aimed at improving Star ratings, HEDIS , CAHPS, and other quality metrics. + Assists call center pharmacy ... Manager . + Identifies and implements programs to improve clinical outcomes stemming from medication selection, utilization, and adherence. **JOB QUALIFICATIONS**… more
    Molina Healthcare (07/27/25)
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  • PRN - Virtual Physician Collaborator (Remote)

    CenterWell (Atlanta, GA)
    …telemedicine/telehealth . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality indicators . Experience working in value-based care settings ... Clinical Leadership. . Meet with clinic leaders about quality of care, review of outcome data, policy, procedure,...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
    CenterWell (08/02/25)
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  • Nurse Practitioner / Physician Assistant

    CenterWell (Augusta, GA)
    …environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. **Additional Information:** + Guaranteed base salary + ... coding specificity. . Follows policy and protocol defined by Clinical Leadership. . Meets with RMD about quality...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
    CenterWell (06/25/25)
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