- Humana (Albany, NY)
- …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 (Syracuse, NY)
- …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 (Yonkers, NY)
- …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
- Highmark Health (Buffalo, NY)
- …is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office based support to ... PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value creation, cost control… more
- Humana (Albany, NY)
- …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
- MVP Health Care (Schenectady, NY)
- …quality operations. + Possess strong personnel management skills. + Experience with HEDIS , Medicare Stars, and NYSDOH QARR reporting requirements. + Possess strong ... Lead and execute quality analytics to support organizational excellence. + Manage annual HEDIS data submissions, including completion of the HEDIS Roadmap, audit… more
- Two95 International Inc. (New York, NY)
- …SPSS, and/or open-source including Python and R, or similar * Deep familiarity with HEDIS & CMS care quality measures; experience implementing both HEDIS and CMS ... measures using SAS and/or SQL * Attitude: A generally positive demeanor and outlook, works well with others and is community-minded, has a proactive leadership orientation, and enjoys contributing through work * Healthcare Domain Knowledge: Conceptual… more
- Centene Corporation (New York, NY)
- …of care + Collaborate with providers to share quality performance data (eg, HEDIS , CAHPS) and support improvement initiatives. + Educate members on preventive care, ... with Medicaid / Medicare programs and quality measures (eg, HEDIS ) required Strong communication and interpersonal skills **Licenses/Certifications:** LCSW- License… more
- Molina Healthcare (Buffalo, NY)
- …* 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 (Albany, NY)
- …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