- Humana (Tallahassee, FL)
- …of high- quality , compliant home health services. This role sets the quality strategy , designs audit frameworks, monitors performance metrics, and drives ... for leading the development, implementation, and oversight of the Quality Assurance and Performance Improvement (QAPI) Program ...Support staff training on clinical operations, regulatory standards, and quality programs . + Travel: Up to 15%… more
- Molina Healthcare (Tampa, FL)
- …EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of ... Plan Risk and Quality leaders to improve outcomes by managing Risk/ Quality data collection strategy , analytics, and reporting, including but not limited… more
- AdventHealth (Altamonte Springs, FL)
- …expert and executive sponsor with responsibility for developing and executing a comprehensive quality management program that drives high-value care to ... Quality will be responsible for leading a comprehensive quality management program encompassing both... databases (Vizient, Premier, Quantros, etc) Experience with national quality programs (Leapfrog, CMS 5-Star,… more
- ChenMed (Hallandale Beach, FL)
- …identified as at risk for non-adherence to chronic medications, focusing on CMS quality measure drug classes (eg, diabetes, hypertension, cholesterol) and ... to optimize medication use, improve patient outcomes, and enhance CMS Star Ratings and HEDIS quality measures....immunization is a plus + Completion of Medication Therapy Management certificate program or Ambulatory Care Certificate… more
- HCA Healthcare (Tampa, FL)
- …will act as a resource for CMS regulatory and outcomes monitoring programs ; for federal reporting system (s); and for Joint Commission sentinel event ... As our new Director, you will be responsible for supporting the Division Quality and Clinical Operations strategy by coordinating activities related to… more
- Humana (Tallahassee, FL)
- …initiatives. **Role Responsibilities:** + Oversight of related budget, vendor relationships, and program / project management + Serve as the primary liaison for ... Qualifications** + Bachelor's degree + 8-9 + years of quality improvement, developing & advancing enterprise strategy ,...center, enrollment, etc. + 5 years or more of CMS Stars program experience + Medicare Advantage… more
- Humana (Tallahassee, FL)
- …claims data used in **HEDIS measurement** + Familiarity with ** CMS Stars programs ** , NCQA standards, and quality performance metrics. + Advanced experience ... strategy , and roadmap for data products that enable CMS Stars and HEDIS reporting. Ensure alignment with enterprise...Knowledge of NCQA, CMS , and health plan quality measurement programs . + Deep understanding of… more
- Molina Healthcare (Tampa, FL)
- …other standards and requirements pertaining to delegation agreements. Contributes to overarching strategy to provide quality and cost-effective member care. This ... with preparation of delegation summary reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. +… more
- Molina Healthcare (Jacksonville, FL)
- …and ability to learn new programs . Preferred Qualifications * Experience with utilization/ quality program management . * Managed care experience. * Peer ... health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job… more
- Oracle (Tallahassee, FL)
- …, care delivery, and payer programs . + Enable **global and US regulatory content and policy development** to inform product strategy . + Ensure that our ... the healthcare ecosystem - including US federal and state programs (eg, CMS , ACOs, value-based care), as...**Responsibilities** **What You'll Do** + **Own regulatory & clinical program strategy ** : Define and evolve the… more