- Excellus BlueCross BlueShield (Rochester, NY)
- …as DOH, CMS, Medicaid, and accreditation requirements such as NCQA, URAC and HEDIS functionalities are met or exceeded. Accesses Health Commerce System (HCS) and ... complete/maintain all mandatory trainings as required. + May be required to attend Fair Hearings with Medical Director relating to specific cases. + Works independently, as well as collaboratively, with members and internal/external stakeholders, resulting in… more
- JPMorgan Chase (New York, NY)
- …and standardizations, groupers, data transformations (eg, TUVA) and logic (eg, HEDIS rules) + Strong understanding of data warehousing concepts, data modeling ... techniques, and data quality principles + Proficiency in creating and maintaining data models, data marts, and ETL processes + Proven ability to successfully multitask effectively, balance competing priorities, and design creative solutions + Team-oriented… more
- Evolent (Albany, NY)
- …global workforce and a working knowledge of clinical quality metrics such as HEDIS and NCQA - Preferred. + Skilled in inpatient and outpatient utilization ... management. - Preferred + 2 - 4 years of operations and Utilization Management experience in a population management or managed care/insurance or hospital medical management department setting may be substituted for associate degree. Experience in consulting… more
- Catholic Health (Kenmore, NY)
- …certification preferred. + Knowledge of Patient Centered Medical Home, with MIPS, HEDIS requirements preferred WORKING CONDITIONS: + Work is demanding and stressful ... at times. + Visual and auditory acuity are essential. + Works indoors in a well-lit, well-ventilated area. + May be exposed to communicable diseases. + Possible On-call coverage REQNUMBER: 39014 more
- Catholic Health (Orchard Park, NY)
- …but not required + Knowledge of Patient Centered Medical Home, with MIPS, HEDIS requirements preferred (Primary Care) WORKING CONDITIONS: + Ability to travel to and ... work at other Trinity Medical facilities and/or physician practice offices + May be exposed to infections and contagious diseases + Occasional exposure to unpleasant patient elements + Contact with patients under wide variety of circumstances + May be exposed… more
- Elevance Health (Latham, NY)
- …adherence to National Committee for Quality Assurance (NCQA) standards and HEDIS reporting. + Hires, trains, coaches, counsels, and evaluates performance of ... direct reports. **Minimum Qualifications:** + Requires BA/BS and minimum of 5 years of experience in Health Care Management; or any combination of education and experience, which would provide an equivalent background. + Current active unrestricted RN, PA,… more
- Catholic Health (Niagara Falls, NY)
- …certification preferred. + Knowledge of Patient Centered Medical Home, with MIPS, HEDIS requirements preferred WORKING CONDITIONS: + Work is demanding and stressful ... at times. + Visual and auditory acuity are essential. + Works indoors in a well-lit, well ventilated area. + May be exposed to communicable diseases. + Possible On-call coverage REQNUMBER: 33502 more
- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Quality and HEDIS data analysis and reporting experience preferred.** **Position Purpose:** Plans, ... organizes, and monitors quality related projects to deliver defined requirements and meet company strategic objectives. + Support enterprise-wide quality initiatives by analyzing and researching potential issues within quality metrics and goals of health plan… more
- Catholic Health (West Seneca, NY)
- …communication skills + Knowledge of Patient Centered Medical Home, with MIPS, HEDIS requirements preferred WORKING CONDITIONS: + Ability to travel to and work ... at other Trinity Medical facilities and/or physician practice offices. + May be exposed to infections and contagious diseases + Occasional exposure to unpleasant patient elements + Contact with patients under wide variety of circumstances + May be exposed to… more
- Catholic Health (Williamsville, NY)
- …the department + Knowledge of Patient Centered Medical Home, with MIPS, HEDIS requirements preferred (Primary Care) WORKING CONDITIONS: ENVIRONMENT + Ability to ... travel to and work at other Trinity Medical facilities and/or physician practice offices + Normal heat, light space, and safe working environment; typical of most office jobs. + Intermittent exposure to a few unpleasant physical conditions. REQNUMBER: 37672 more