- CenterWell (Atlanta, GA)
- …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
- Molina Healthcare (Atlanta, GA)
- …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
- Molina Healthcare (GA)
- …+ 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 (Suwanee, GA)
- …years MA experience + Value Based Care experience including knowledge of HEDIS , CPT/ICD coding, and CAHPS/HOS Patient Experience. **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 time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based… more
- CenterWell (Atlanta, GA)
- …+ Experience with primary care house calls + Familiarity with value-based care, HEDIS metrics Step into a career that's challenging, rewarding, and full of purpose. ... Be a catalyst for change-impact lives, shape the future, and grow with a team that puts patients first. \#LI-DH1 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours**… more
- CenterWell (Stone Mountain, GA)
- …Medicare guidelines and coverage . Bilingual is a plus . Knowledge of HEDIS quality indicators **Additional Information:** . Total compensation package (base pay + ... bonus) could exceed $300K depending on experience and location . Excellent benefit package - _health insurance effective on your first day of employment_ . CME Allowance/Time . Occurrence Based Malpractice Insurance . Relocation and sign-on bonus options .… more
- CenterWell (Augusta, GA)
- …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 **Additional Information** This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to… more
- Elevance Health (Atlanta, GA)
- …+ Support the transition of care process. + Assist providers and patients with HEDIS gap closures and HRA compliance. + Associates in this role are expected to ... have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers. + Additional expectations to include but not limited to: Proficient in maintaining focus during… more
- Molina Healthcare (Savannah, GA)
- …policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS , Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, ... capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease management, and evidence-based guidelines. + Experience in Utilization/Quality Program management +… more
- Molina Healthcare (Atlanta, GA)
- …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