- Molina Healthcare (Houston, TX)
- …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
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Manager Quality Improvement manages people and develops programs , and projects to achieve transformation and sustainable change that support ... the BSWH strategy to deliver high- quality , safe care and...and performance evaluation. **KEY SUCCESS FACTORS** Expert knowledge in quality performance measurement, data analysis, and project management… more
- Humana (Austin, TX)
- …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 (Austin, TX)
- …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 (TX)
- …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 (Houston, TX)
- …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
- RTX Corporation (Richardson, TX)
- …Financial Plan inputs in partnership with Operations, Engineering, and Business Development ** Program Execution and Strategy ** + Set and execute short-, mid-, ... and presentation of Estimates at Completion (EACs) and ensure compliance with EVMS, CMS /RLPM, and quality requirements + Champion innovation by challenging the… more
- CenterWell (Austin, TX)
- …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
- Texas Health Resources (Arlington, TX)
- …Coordinators for organization of grievance process. Provide onboarding and orientation to the system grievance program and management of Feedback related ... organizational goals for patient family engagement. * Develop and implement of grievance management program . Serves as a resource for efforts with education and… more
- Molina Healthcare (Austin, TX)
- …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