- Molina Healthcare (Yonkers, NY)
- …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
- Centene Corporation (New York, NY)
- …with occasional travel to Bedford, NH!** **Position Purpose:** Lead and direct process improvement activities that provide more efficient and streamlined ... Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set ( HEDIS ) performance. + Ensure health plan is compliant and become/remain… more
- Molina Healthcare (Syracuse, NY)
- … 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
- Excellus BlueCross BlueShield (Rochester, NY)
- …is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical Services area ... medical policies, guidelines and medical criteria. + Assists with training medical director colleagues and nursing staff , including leadership of teaching grand… more
- MVP Health Care (Schenectady, NY)
- …evaluate and research medical literature is essential + Knowledge of quality improvement including HEDIS , STAR, CAHPS measures is preferred. + Knowledge ... for everyone - which requires innovative thinking and continuous improvement . To achieve this, we're looking for a **Medical.... To achieve this, we're looking for a **Medical Director , Post-Acute Care Utilization Management** to join #TeamMVP. If… more