- Molina Healthcare (NY)
- …BH services/resources and community supports is highly preferred. Skilled in closing HEDIS and preventive care gaps through proactive outreach and coordination with ... members and providers. Experience integrating medical and Behavioral health needs in care planning. The candidate must understand clinical guidelines, social determinants of health, and health equity principles. Case management and managed care experience is… more
- Centene Corporation (Maumee, OH)
- …states, and have a (2) combination of experience in the following areas: HEDIS , managed care, quality, process improvement/ project management (such as lean, CPHQ, ... IHI training).** **Additional Details:** Department: MED-Quality Improvement** Business Unit: Buckeye Community Health Plan** Schedule: Monday through Friday, 8am-5pm eastern **Position Purpose:** Plans, organizes, and monitors quality related projects to… more
- Elevance Health (Grand Prairie, TX)
- …medication adherence-related topics to align closely with STARs Ratings and HEDIS quality measures. + Assists members with scheduling their preventive ... test/screenings and medication resources or assistance programs. + Makes outreach to members or providers to close care gaps and improve outcomes. **Minimum Requirements:** + Requires an active, professional license, if required by state law, State Pharmacy… more
- CVS Health (Columbus, OH)
- …departments to develop and implement patient safety initiatives that align with HEDIS measures. + **Financial Management:** Managing the pharmacy budget is an ... important aspect of the role. The Pharmacy Director works closely with the Chief Financial Officer (CFO) and Actuary team to develop and monitor budgets, analyze financial data, identify cost-saving opportunities, and optimize medication-related expenditures.… more
- CenterWell (Las Vegas, NV)
- …environment + Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality indicators + Bilingual is a plus **Additional Information** Scheduled 8:00 ... am to 5:00 pm \#physiciancareers \#LI-157966401_KT1 **Scheduled Weekly Hours** 1 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range… more
- CenterWell (Columbia, SC)
- …of Medicare guidelines and coverage + Bilingual is a plus + Knowledge of HEDIS quality indicators + Guaranteed base salary + quarterly bonus + Excellent benefit ... package - **_health insurance effective on your first day of employment_** + CME Allowance/Time + Relocation and sign-on bonus options + 401(k) with Employer Match + Life Insurance/Disability + Paid Time Off/Holidays + Minimal call \#physiciancareers \#LI-JB3… more
- CenterWell (Fort Worth, TX)
- …in PCO center + 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
- AmeriHealth Caritas (Dover, DE)
- …providers, and other organizations. + Inform members of required actions to meet HEDIS , EPSDT, and Plan requirements through phone calls or home visits, and ... encourage compliance. + Help address barriers to care and foster relationships between members and their medical/dental providers. + Complete additional task-based assignments as directed by leadership. **Education & Qualifications:** + Associate's degree in… more
- Centene Corporation (Jefferson City, MO)
- …+ 2+ years of experience with STAR measures + 3+ years of experience in HEDIS + 2+ years of experience with supplemental and medical record review activities + 2+ ... years of leadership experience preferred **Education/Experience:** Bachelor's degree in related field or equivalent experience. 5+ years of training experience within the hiring departments function, preferably in a managed care/insurance environment.… more
- Mount Sinai Health System (New York, NY)
- …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 ... consulting actuarial, financial reporting or medical economics departments highly valuable. + Experience as a nurse informaticist highly valuable. + Experience working in healthcare provider analytics related to revenue modeling, managed care contracting,… more