- Premera Blue Cross (Mountlake Terrace, WA)
- …regulatory and accreditation requirements (ACA, WA OIC, AK DOI, NCQA, HEDIS ). Support medical management and clinical pharmacy initiatives through research, ... analyses, and administration of clinical drug utilization management programs. + Assist in administering Pharmacy Prior Authorization and other clinical pharmacy programs. Identify and help resolve drug-related issues in collaboration with medical services… more
- Molina Healthcare (WA)
- …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
- Evolent (Olympia, WA)
- …+ Experience with value-based care, utilization management, or regulatory reporting (eg, HEDIS , NCQA, Milliman). **To comply with HIPAA security standards (45 CFR ... sec. 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final interview state. Reasonable accommodations are… more
- Elevance Health (Seattle, WA)
- …members on medication adherence-related topics to align closely with STARs Ratings and HEDIS quality measures. + Conducts outreach to members or providers to close ... care gaps and improve outcomes, while also facilitating the scheduling of preventive tests or screenings and providing access to medication resources or assistance programs for members. **Minimum Requirements:** + Requires an active, professional license, if… more
- CVS Health (Olympia, WA)
- …related role. + 2+ years of process improvement experience related to HEDIS measures. + In-depth knowledge of healthcare regulations, clinical operations, quality ... standards, and performance metrics. + Strong analytical and problem-solving skills, with the ability to interpret complex data sets and identify improvement opportunities. + Excellent communication, presentation and interpersonal skills to collaborate with and… more
- Molina Healthcare (Vancouver, WA)
- …* Maintain fluency in healthcare data types (eg, ICD/CPT codes, HEDIS measures, member eligibility) to guide technical decisions. **JOB QUALIFICATIONS** **Required ... Education** * Bachelor's or Associate's degree in Data Science, Computer Science, Analytics, Information Systems, Engineering, or other technology-related fields **Required Experience** + 3-5 years of experience working with **healthcare data** in an analytics… more
- Sea Mar Community Health Centers (Ocean Shores, WA)
- …to health centers or hospitals + Focus clinic efforts on quality measures, HEDIS , and Meaningful Use standards + Provide annual MA trainings (Infection control, ... sterilization techniques, etc ) + Lead hiring efforts for any MAs and participate in the hiring of other support staff + Oversee and maintain a patient care system of nurse only visits. + Good communication (both written and verbal) and team building skills… more
- Sea Mar Community Health Centers (Vancouver, WA)
- …to health centers or hospitals. + Focus clinic efforts on quality measures, HEDIS , and Meaningful Use standards. + Provide annual MA trainings (Infection control, ... sterilization techniques, etc ). + Lead hiring efforts for any MAs and participate in the hiring of other support staff. + Oversee and maintain a patient care system of nurse only visits. Requirements: + Must have graduated from an accredited college or… more
- Molina Healthcare (Spokane, WA)
- …(CPHQ) + Nursing License (RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested ... in applying for this position, please apply through the intranet job listing Molina Healthcare offers a competitive benefits and compensation package Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V \#PJCorp \#LI-AC1 Pay Range: $54,922 -… more
- Molina Healthcare (Tacoma, WA)
- …operations. + Maintain fluency in healthcare data types (eg, ICD/CPT codes, HEDIS measures, member eligibility) to guide technical decisions. REQUIRED EDUCATION: + ... Bachelor's or Associate's degree in Data Science, Computer Science, Analytics, Information Systems, Engineering, or other technology-related fields **REQUIRED EXPERIENCE / SKILLS:** + 3-5 years of experience working with **healthcare data** in an analytics or… more