• Lead Abstractor, HEDIS / Quality

    Molina Healthcare (Atlanta, GA)
    **Job Description** **Job Summary** Molina's Quality Improvement Lead Abstractor conducts data collection and abstraction of medical records for HEDIS ... Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS...abstracted records as required by specifications. + Assists the quality improvement staff with physician and member… more
    Molina Healthcare (08/08/25)
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  • Risk & Quality Performance Manager

    Molina Healthcare (Savannah, GA)
    **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of experience supporting HEDIS engine activity, risk… more
    Molina Healthcare (07/31/25)
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  • Health Care Quality Senior Manager

    CVS Health (Atlanta, GA)
    …into their strategic and operational plans . Evaluates and prioritizes recommendations for quality improvement to senior health plan management . Develops and ... Aggregative Performance Improvement Projects meeting "pass" criteria Performance tracking for HEDIS measures + Triple weighted + MTMM + MTTMM+ Triple weighted by… more
    CVS Health (08/08/25)
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  • Provider Engagement Account Manager

    Centene Corporation (Atlanta, GA)
    improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS / quality , cost and utilization, etc. + Completes special projects as assigned ... experience at a medical group, IPA, or health plan setting. Proficient in HEDIS / Quality measures, cost (MLR) and utilization Pay Range: $55,100.00 - $99,000.00… more
    Centene Corporation (08/08/25)
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  • Senior Client Coding Project Manager

    Datavant (Atlanta, GA)
    …collaboration with those responsible for coder performance management. + Drive quality assurance and performance improvement activities for coding projects. ... vision for healthcare. As a Sr. Client Coding Project Manager , you will plan, forecast, and manage client-facing coding...coding and management tools, and ensuring alignment on coding quality . + Oversee the coding phase of client projects… more
    Datavant (06/28/25)
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  • Consultative Coding Professional

    CenterWell (Atlanta, GA)
    …and coding. + Based on one-on-one engagement with clinicians, identify documentation improvement areas and partner with clinical and coding education to deliver ... education related to improvement opportunities + Analyze trends, triage, and answer questions in real-time. + Research and interpret correct coding guidelines and… more
    CenterWell (08/08/25)
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  • Senior Specialist, Member & Community…

    Molina Healthcare (GA)
    …maintain critical program milestones, deadlines, and/or deliverables + Participates in quality improvement activities, meetings, and discussions with and between ... organizations + Evaluates project/program activities and results to identify opportunities for improvement + Surfaces to the Manager and Director any gaps… more
    Molina Healthcare (07/31/25)
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  • Primary Care Physician Lead

    CenterWell (Savannah, GA)
    …+ Participating in Shared Service Strategy Meetings + Participating in quality improvement programs, population health programs, continuing education, and ... + Advance the Model of Care + Create profit improvement initiatives + Design operational implementations + Contribute to...Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of… more
    CenterWell (06/27/25)
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  • Care Management Support Professional

    CenterWell (Atlanta, GA)
    …Proficiency in using scheduling and business management software. + Well-versed in quality and process improvement initiatives. Dedication to maintaining high- ... team members. Manage inventory, including ordering of necessary supplies. Lead quality initiatives to improve market performance, focusing on patient and provider… more
    CenterWell (08/08/25)
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  • Senior Integrated Clinical Pharmacist Bilingual

    CenterWell (Atlanta, GA)
    …for patients on appropriate use of medications and self-management + Engage in quality improvement initiatives aimed at enhancing medication safety and efficacy ... or clinical management systems + Support CMS Stars and HEDIS quality measures for successful clinic performance...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
    CenterWell (07/26/25)
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