- Molina Healthcare (MI)
- …member/ provider ( HEDIS ) outreach and/or quality intervention or improvement studies (development, implementation, evaluation) and Director level experience. ... subject matter expert and lead for Molina Plan quality improvement HEDIS operations using a defined roadmap,...at least 4 years in health plan quality or process improvement or equivalent/related experience. * Operational… more
- Molina Healthcare (Sterling Heights, MI)
- … activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, ... necessity. + Participates in and maintains the integrity of the appeals process , both internally and externally. Responsible for the investigation of adverse… more
- Molina Healthcare (Detroit, MI)
- …nature of the performance measurement data collection, reporting and monitoring process , including HEDIS , state-based measure reporting and medical record ... the soundness and correctness of data used to create HEDIS results. Manages state's annual CAHPS survey process...Defines use of in-house vs. vendor strategy for each HEDIS season. + May implement improvement activities… more