- Centene Corporation (Houston, TX)
- …performance + Drives provider performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + ... relations to ensure delivery of the highest level of care to our members. Engage with providers to align...Project management experience at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures,… more
- Molina Healthcare (Austin, TX)
- **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... in alignment with RQS's strategic objectives. **Job Duties** * Collaborate with Health Plan Risk and Quality leaders to improve outcomes by managing Risk/Quality… more
- Evolent (Austin, TX)
- …Working across specialties and primary care , we seek to connect the pieces of fragmented health care system and ensure people get the same level of care ... results, and collaborating with others. **Collaboration Opportunities:** + The Manager , Client Services oversees daily utilization management and directs...care of our members on behalf of our health plans and serves in a supporting role to… more
- Datavant (Austin, TX)
- … health technology company that rewards our employees for transforming health care through creating industry-defining data logistics products and services. ... a data platform company and the world's leader in health data exchange. Our vision is that every healthcare...government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a… more
- CenterWell (Port Arthur, TX)
- …of senior-focused primary care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on ... provider relationships across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements +… more
- Elevance Health (Houston, TX)
- …and high-quality clinical documentation. + Chart reviews for closing HEDIS care opportunities to ensure practice and health plan success. + Liaison ... exists to enable individuals in home and community-based settings to maximize their health , independence, and quality of life through home- care and community… more
- Molina Healthcare (Houston, TX)
- …for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of the Plan's patients or members. * Oversees and ... and must live in Texas _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network… more
- CenterWell (Arlington, TX)
- …of senior-focused primary care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on ... hospital and SNF coordination, durable medical equipment and home health care . + Acts as an active...Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality indicators **Additional Information** + Guaranteed base salary… more
- CenterWell (Alice, TX)
- …of senior-focused primary care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care . + Acts as anactive participant and key source of… more
- CenterWell (San Antonio, TX)
- …of senior-focused primary care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on ... hospital and SNF coordination, durable medical equipment and home health care . + Acts as an active...Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality indicators + Bilingual in English and Spanish… more