- Humana (Atlanta, GA)
- …demonstrate expertise and business intelligence in supporting execution of the HEDIS program and related activities, all within tightly regulated requirements and ... Compliance, and Risk Adjustment, as well as vended partners. The Senior HEDIS Operations & Quality Professional supports all aspects of the non-standard supplemental… more
- Molina Healthcare (Savannah, GA)
- …Quality Reporting team. Designs and develops reporting solutions to assist HEDIS Outbound, Inbound extracts, Data Ingestions, Dashboards, Reports & Extracts for ... Experience** * 5+ Years of experience in working with ** HEDIS ** tools such as **Inovalon** or **ClaimSphere** * 5+...**ClaimSphere** * 5+ Years of experience in working with HEDIS Domain - such as Measure analysis/reconciliation on data… more
- Molina Healthcare (Macon, GA)
- …Quality Analytics team. Designs and develops reporting solutions to assist HEDIS audit, rate tracking, and Identifying targeted Interventions and tracking outcome. ... tracking of progress and impact of such interventions. + Assist retrospective HEDIS rate tracking and supplemental data impact reporting. + Develop Medical Record… more
- Humana (Atlanta, GA)
- …to drive the development of data products specifically related to CMS Stars and HEDIS quality measures. The ideal candidate has deep expertise in Stars/ HEDIS ... strategy, and roadmap for data products that enable CMS Stars and HEDIS reporting. Ensure alignment with enterprise goals and departmental priorities. + **Backlog… more
- ChenMed (Forest Park, GA)
- …exam rooms and ensures their comfort and well-bring prior to leaving. + Acts as HEDIS champion for the PCP by providing visibility of HEDIS needs for scheduled ... patients. Reports on hospitalizations including HITS census, ENS Ping, etc. + Presents patients with customer service survey during check out and escalates if needed for immediate service recovery. + Participates in daily and weekly huddles to provide details… more
- ChenMed (Morrow, GA)
- …exam rooms and ensures their comfort and well-bring prior to leaving. + Acts as HEDIS champion for the PCP by providing visibility of HEDIS needs for scheduled ... patients. + Presents patients with customer service survey during check out and escalates if needed for immediate service recovery. + Participates in daily and weekly huddles to provide details on patients. **_Other responsibilities may include:_** + Maintains… more
- Centene Corporation (Atlanta, GA)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... experience at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization. Pay Range: $55,100.00 - $99,000.00 per year… more
- Centene Corporation (Atlanta, GA)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
- Molina Healthcare (Macon, GA)
- …* Knowledge of health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) * Knowledge of health care ... 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
- CVS Health (Atlanta, GA)
- …to clinical or quality measurement problems (eg, HOS, HRA, CAHPS, or HEDIS ). + Proven success communicating complex findings to non-technical business partners and ... influencing decision-making. + Ability to work effectively in a fast-paced, cross-functional environment. **Preferred Qualifications** + Master's or PhD in Data Science, Statistics, Epidemiology, Public Health, or a related quantitative field. + Familiarity… more