- CVS Health (Phoenix, AZ)
- …reporting requirements and contributes to the development and execution of HEDIS strategy to ensure compliance and optimize performance in quality measurement ... and qualitative data analysis to strategize and achieve operational targets for NCQA HEDIS and Medicare Stars * Provide analysis support for PIP reports to… more
- CenterWell (Phoenix, AZ)
- …opportunities. + Perform individual chart research as requested. + Collaborate with HEDIS leaders and champions to identify HEDIS gaps and deficiencies. ... + Participate in Payer calls/chart reviews. + Compile payer findings and assist with research. + Participate in payor meetings/discussions to ensure accurate data submission. **Use your skills to make an impact** **Required Qualifications:** + A minimum of… more
- Highmark Health (Phoenix, AZ)
- …methodologies and reporting/regulatory requirements and CMS Stars rating measures including HEDIS , CAHPS, Pharmacy, HOS, PQA, PQRS. + Supportdevelopment of the ... strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS , risk revenue value streams, and population health management. **Preferred** + 7… more
- Molina Healthcare (Phoenix, AZ)
- …to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success. * Partner with other teams to ensure data quality ... experience in risk adjustment and/or quality * 2+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems * 2+ years of… more
- CenterWell (Mesa, AZ)
- …years MA experience * Value Based Care experience including knowledge of HEDIS , CPT/ICD coding, and CAHPS/HOS Patient Experience. * Bilingual proficiency in English ... and Spanish - must pass proficiency exam prior to foreign language communication **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the… more
- Molina Healthcare (AZ)
- …+ Knowledge of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare ... financial terms (eg, PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such… more
- Centene Corporation (Phoenix, AZ)
- …data entry, tracking, organizing, and researching information + Assist with HEDIS production functions including data entry, calls to provider's offices, and ... claims research. + Manage large volumes of documents including copying, faxing and scanning incoming mail + Performs other duties as assigned. + Complies with all policies and standards. Must live in Arizona Claims and Provider Dispute experience preferred… more
- CenterWell (Sun City, AZ)
- …environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. + Bilingual is a plus. **Additional Information** + Guaranteed ... base salary + quarterly bonus + Excellent benefit package - **_health insurance effective on your first day of employment_** + CME Allowance/Time + Occurrence Malpractice Insurance + 401(k) with Employer Match + Life Insurance/Disability + Paid Time… more
- Molina Healthcare (Mesa, AZ)
- …sources. + Knowledge of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare ... financial terms (eg, PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such… more
- CenterWell (Peoria, AZ)
- …required pharmacy or clinical management systems + Support CMS Stars and HEDIS quality measures for successful clinic performance + Maintain accurate and thorough ... documentation of clinical interventions and patient care activities + Conduct in-service education and training sessions for healthcare staff as well as develop and disseminate educational materials related to pharmacotherapy + Stay current with advancements… more