- Northern Light Health (Brewer, ME)
- …of all agreements. This includes, but is not limited to, MIPS, eCQMs, HEDIS and CGCAHPS for ambulatory quality and IQR, QHIP, Leapfrog, Medicare Star Ratings, ... and HCAHPS for inpatient quality. The coordinator will provide guidance to data and programming experts to ensure all relevant information is collected and captured and ensure accurate capture and reporting through extensive auditing and validation processes.… more
- Evolent (Lincoln, NE)
- …+ Experience with value-based care, utilization management, or regulatory reporting (eg, HEDIS , NCQA, Milliman) is preferred. To ensure a secure hiring process we ... have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive… more
- CDPHP (Latham, NY)
- …all regulatory requirements are being met, such as NYS DOH, CMS, NCQA, and HEDIS , serving as internal auditor within the group. + Responsible for all aspects of ... the Case Management department functions including quality, productivity, utilization performance, and educational needs to address established policies and procedures and job responsibilities. Qualifications: All Levels + Associates degree required.… more
- CenterWell (Orlando, FL)
- …+ Daily working of reports in Data hub for EDAPS and HEDIS , help manage employees, assisting and learning the Administrators role. **Required Qualifications:** ... + **Must be Bilingual in English and Spanish** + 1+ years of supervisory/leadership experience in a healthcare setting + Progressive experience in managed care contracting and / or provider relations + Excellent customer service, organizational skills and… more
- CenterWell (San Antonio, TX)
- …environment** **Knowledge of Medicare guidelines and coverage** **Knowledge of HEDIS quality indicators** **Bilingual English/Spanish. Must be able to speak, ... read and write in both languages without limitations or assistance. See Additional Information on testing** **Additional Information:** **Guaranteed base salary + bi-annual bonus** **Excellent benefit package -** **_health insurance effective on your first day… more
- CenterWell (Greensboro, NC)
- …MA experience + Value Based Care experience including knowledge of HEDIS , CPT/ICD coding, and CAHPS/HOS Patient Experience. + Bilingual **Additional Information** ... **_This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB._** **_As part of our hiring process for this opportunity, we will be using… more
- CenterWell (Lutz, FL)
- …of MA experience + Value Based Care experience including knowledge of HEDIS , CPT/ICD coding, and CAHPS/HOS Patient Experience. + Phlebotomy experience + Bilingual ... proficiency in English and Spanish - must pass proficiency exam prior to foreign language communication **Working hours** : Monday to Friday 8AM-5PM **Additional Information** **Alert** Humana values personal identity protection. Please be aware that… more
- Centene Corporation (Austin, TX)
- …associates to interpret and act on financial and quality metrics (eg, HEDIS , STARs) to drive targeted improvement strategies. + **Coach on Engagement Strategies:** ... Educate market teams on building strong provider relationships, optimizing incentive programs, and implementing value-based care models. **_ _** **Position Purpose:** The Regional Provider Engagement Manager will support provider performance and engagement… more
- CenterWell (Tampa, FL)
- …to obtain DEA license and/or Medicaid and Medicare numbers + Familiarity with HEDIS quality indicators and Medicare guidelines. **Use your skills to make an impact** ... **Compensation & Benefits** + Competitive base salary + annual bonus + Health insurance effective Day 1 + 401(k) with employer match + CME allowance + dedicated CME time + Occurrence-based malpractice coverage + Life & disability insurance + Generous PTO &… more
- CenterWell (Lexington, KY)
- …environment + Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality indicators **Compensation & Benefits** + Competitive base salary + annual ... bonus + Health insurance effective Day 1 + 401(k) with employer match + CME allowance + dedicated CME time + Occurrence-based malpractice coverage + Life & disability insurance + Generous PTO & paid holidays + Minimal call responsibilities **Scheduled Weekly… more