- Humana (Montgomery, AL)
- …management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as ... they relate to provider performance, member experience, market growth, provider experience and operational excellence. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting… more
- CenterWell (Alice, TX)
- …professional Phlebotomy experience + Experience with Electronic Medical Records + Experience with HEDIS + Must be able to work at the Conviva Care clinic located ... at: **9727 Poteet Jourdanton Freeway, Suite 108, San Antonio, TX 78211** **Preferred Qualifications** + IV Certified + Knowledge of primary care medicine requirements (state specific). + Bilingual in English and Spanish, with the ability to speak to patients… more
- Humana (Baton Rouge, LA)
- …& requisition requests for department members. *Oversee Quality Improvement and HEDIS /STARS metrics improvement with PCP offices and IPAs. *Participate in regional ... level committees and meetings setting medical necessity strategies. *Provide oversight and direction for the implementation of regional clinical programs and strategies, as well as, developing and implementing market level strategies. *Manage internal… more
- Centene Corporation (Harrisburg, PA)
- …data entry, tracking, organizing, and researching informatio + Assist with HEDIS production functions including data entry, calls to provider's offices, and ... claims research. + Manage large volumes of documents including copying, faxing and scanning incoming mail + Performs other duties as assigned. + Complies with all policies and standards. **Education/Experience:** High school diploma or equivalent. Associate's… more
- Elevance Health (Costa Mesa, CA)
- …stakeholders. + Preference will be given to candidates with experience in HEDIS /Quality measures data analytics. For candidates working in person or virtually in ... the below location(s), the salary* range for this specific position is $87,032 to $136,224 Locations: California In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity… more
- Elevance Health (Tampa, FL)
- …adherence to National Committee for Quality Assurance (NCQA) standards and HEDIS reporting. + Hires, trains, coaches, counsels, and evaluates performance of ... direct reports. **Minimum Requirements:** + Requires BA/BS and minimum of 5 years of experience in Health Care Management; or any combination of education and experience, which would provide an equivalent background. + Current active unrestricted RN, PA, LSW,… more
- Centene Corporation (New York, NY)
- …to improve member outcomes. + Conduct Quality Measure outreach campaigns for HEDIS measures such as ADD, adherence outreaches for MAT medications, Antidepressant, ... Antipsychotic medications, or confirmation of lab work. + Perform comprehensive Medication Reconciliation reviews to identify and recommend targeted clinical interventions in collaboration with various Case Management team for Populations Health Measures such… more
- CenterWell (Jupiter, FL)
- …environment . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality indicators **Additional Information:** . Base salary +bi-annual incentive . ... Excellent benefit package - _health insurance effective on your first day of employment_ . CME Allowance/Time . Occurrence Based Malpractice Insurance . Relocation and sign-on bonus options . 401(k) with Employer Match . Life Insurance/Disability . Paid Time… more
- Humana (Montgomery, AL)
- …Network Performance serves as expert to a team on CMS Stars program, HEDIS , CAHPS, HOS. Decisions are typically related to identifying and resolving complex ... technical and operational problems within department(s) and could lead multiple managers or highly specialized professional associates. The Associate Director, Network Performance is responsible for overseeing the performance and reliability of the… more
- CenterWell (Hammond, LA)
- …years MA experience + Value Based Care experience including knowledge of HEDIS , CPT/ICD coding, and CAHPS/HOS Patient Experience. + Bilingual proficiency in English ... and Spanish - must pass proficiency exam prior to foreign language communication **Additional Information:** This role is considered patient-facing and is part of the company's Tuberculosis (TB) screening program. If selected for this role, you will be… more