- Blue KC (Kansas City, MO)
- …+ Analyze data and monitor provider metrics to identify risk adjustment, HEDIS or educational opportunities for the Medicare Advantage and Qualified Health Plan ... + Develop educational tools for network providers regarding risk adjustment and HEDIS documentation and coding best practices to facilitate risk adjustment gap… more
- CVS Health (Richmond, VA)
- …protocols and practice guidelines Work in partnership with the Senior and Field Educators, and Senior Clinicians to ensure effective programs for provider training, ... and effective action plans to maintain clinical excellence at all times. (eg HEDIS , NPS, RVUs, etc) Understand, articulate and ensure compliance with State Provider… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Care Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift About Us Covenant Medical Group employs or manages ... abreast of most recent changes in quality related to HEDIS measures, CMS Conditions of Participation, MIPS and other...services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory.… more
- University of Southern California (Alhambra, CA)
- …the status and processing of requests received from ambulatory care management nurse . 8. Assesses ongoing discharge planning needs and documents is computer system ... working relationship with care team members, including pharmacy, behavioral health, field team, office staff, and facility staff. 11. Completes Medicare One… more
- University of Miami (Miami, FL)
- …supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of this position ... + Completion of Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge of… more
- Trinity Health (Fresno, CA)
- …requirements of Medicare STARS, Healthcare Effectiveness Data and Information Set ( HEDIS ), and Hierarchical Condition Categories (HCC) with provider staff to ... 1. Bachelor's degree in Nursing, Health Education, or related field is required. High school diploma or equivalent and...or equivalent and current licensure as a Licensed Vocational Nurse (LVN) in the State of California and three… more
- CDPHP (Latham, NY)
- …and scope of practice requirements for each specific health-related field /specialty + Maintains confidentiality and conducts information management procedures per ... Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, Geriatrics, etc.) to ensure continuity and… more
- CVS Health (Columbia, SC)
- …related role. + 2+ years of process improvement experience related to HEDIS measures. + In-depth knowledge of healthcare regulations, clinical operations, quality ... VPN. **Preferred Qualifications:** + Licensed Allied Health Professional or Licensed Registered Nurse + Coding or Sales background + Certified Six Sigma Green Belt… more
- ChenMed (Tampa, FL)
- …and execution of business strategies that increase revenue and quality ratings ( HEDIS /STARS/Clinical Gaps) and support our core model. + Develops protocols and ... in Business or Healthcare Administration or a healthcare related field preferred + Active and good standing Licensed Practical... preferred + Active and good standing Licensed Practical Nurse (LPN) in current state of employment **OR** a… more
- Mount Sinai Health System (New York, NY)
- …Health System. **Qualifications** + BA or BS degree minimum, in a relevant field of study; Masters degree preferred. + Experience in Healthcare Supply Chain highly ... Medicare regulations and related reporting requirements, such as STARS,QARR, MMCOR, MEDS, RAPS and HEDIS is a strong plus. + Experience working in a health plan or… more