- Molina Healthcare (Syracuse, NY)
- …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
- The New Jewish Home (Bronx, NY)
- …to nursing and paraprofessional staff as required. o Leads the quality assessment, quality program management and quality 2. Performance improvement ... develop, implement and refine quality and safety programs at the inter-professional level through consultation, program... subject matter expert with other stakeholders to drive quality management strategy . o Builds… more
- Access: Supports For Living (Middletown, NY)
- …Analysis, Process Mapping, data collection and analysis, pareto diagrams, run charts, Daily Management System and strategy deployment + Assisting with IRC ... or RN OVERVIEW OF PRIMARY RESPONSIBILITES: This position leads and supports a Quality Team which is responsible for: Incident Management , Internal Regulatory… more
- Humana (Albany, NY)
- …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 (Albany, NY)
- …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 (Albany, NY)
- …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
- Rochester Regional Health (Rochester, NY)
- …coding guidelines and proper documentation requirements as it relates to data quality management and reimbursement. + Responsible for the recruitment, selection, ... the long term success of the Clinical Documentation Improvement program at the system level. The Director...of customer service. + Responsible for the development and management of strategy , specific goals, objectives, budgets… more
- CenterWell (Albany, NY)
- …our caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical ... for Medicare and Medicaid Services ( CMS ) and other government agencies. The Program Management Lead, Offshore Coding Operations works on problems of diverse… more
- Molina Healthcare (Buffalo, NY)
- …length of stay and level of care provided to members. Contributes to overarching strategy to provide quality and cost-effective member care. Candidates with UM ... Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ)… more
- Molina Healthcare (Bronx, NY)
- …ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job ... for Quality Assurance, Centers for Medicare and Medicaid Services ( CMS ), and state/federal guidelines and requirements. May also perform non-clinical system… more