- CenterWell (North Charleston, SC)
- …the scope of provider relationships across the following areas: + Quality / clinical management and population health + HEDIS and Stars performance + ... without restriction in applicable state + 5+ years of clinical nursing experience + Proven work experience as a... nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare quality… more
- Centene Corporation (Lubbock, TX)
- …performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS / quality , cost and utilization, etc. + Receive and effectively respond ... years of managed care or medical group experience, provider relations, quality improvement, claims, contracting utilization management, or clinical operations.… more
- Centene Corporation (Jackson, MS)
- …performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS / quality , cost and utilization, etc. + Completes special projects as ... years of managed care or medical group experience, provider relations, quality improvement, claims, contracting utilization management, or clinical operations.… more
- Centene Corporation (Augusta, GA)
- …performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS / quality , cost and utilization, etc. + Completes special projects as ... years of managed care or medical group experience, provider relations, quality improvement, claims, contracting utilization management, or clinical operations.… more
- Centene Corporation (Sacramento, CA)
- …performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS / quality , cost and utilization, etc. + Leveraging data, presents ... or health plan setting. Strong communication and presentation skills Proficient in HEDIS / Quality measures, cost (ie MLR analysis) and utilization metrics. Pay… more
- Sharp HealthCare (San Diego, CA)
- …Professional in Healthcare Quality (CPHQ) - National Association for Healthcare Quality ; Certified Case Manager (CCM) - Commission for Case Manager ... -REQUIRED **Preferred Qualifications** + Master's Degree in nursing, healthcare, quality , or business. + 5 Years clinical ... Quality (CPHQ) - National Association for Healthcare Quality -PREFERRED + Certified Case Manager (CCM)… more
- Centene Corporation (Austin, TX)
- …performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS / quality , cost and utilization, etc. + Present detailed HBR analysis ... years of managed care or medical group experience, provider relations, quality improvement, claims, contracting, utilization management, or clinical operations.… more
- Centene Corporation (Little Rock, AR)
- …performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS / quality , cost and utilization, etc. + Completes special projects as ... years of managed care or medical group experience, provider relations, quality improvement, claims, contracting utilization management, or clinical operations.… more
- Trinity Health (Boise, ID)
- …This position provides education, training, support, and collaboration with primary care clinical teams and providers to support Quality Performance Improvement ... initiatives (Gaps In Care Closure) focused on Quality measures ( HEDIS ). + This position will...and STAR measures. This role reports to the SAMG Manager of Quality Performance Improvement, Population Health.… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case ... drivers. Essential Accountabilities: Level I + Handles physical health member clinical management programs. + Maintains knowledge of current Case Management Society… more