- 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
- 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
- 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
- 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
- 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
- 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 (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
- 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
- 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 (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