- Molina Healthcare (Milwaukee, WI)
- …* Knowledge of health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) * Knowledge of health care ... financial terms (eg, PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form). * Demonstrated understanding of key managed care concepts and provider reimbursement principles such… more
- CVS Health (Jackson, MS)
- …to clinical or quality measurement problems (eg, HOS, HRA, CAHPS, or HEDIS ). + Proven success communicating complex findings to non-technical business partners and ... influencing decision-making. + Ability to work effectively in a fast-paced, cross-functional environment. **Preferred Qualifications** + Master's or PhD in Data Science, Statistics, Epidemiology, Public Health, or a related quantitative field. + Familiarity… more
- MVP Health Care (Schenectady, NY)
- …healthcare data- claims, coding, HIE's etc. Experience with quality metrics, (NCQA HEDIS and NYS QARR) standards strongly preferred + Strong analytical skills, with ... the ability to turn data into actionable insights + Proficiency in SQL, data visualization tools (eg Tableau, PowerBI) + Data Manipulation tools (eg Alteryx, R, Python) beneficial + Excellent verbal and written communication skills, with the ability to… more
- MVP Health Care (Tarrytown, NY)
- …to client care. + Knowledge of Transition of Care (TOC) + Knowledge of HEDIS & Quality Measure + Knowledge of Government Programs + Curiosity to foster innovation ... and pave the way for growth + Humility to play as a team + Commitment to being the difference for our customers in every interaction **Your key responsibilities:** + Conduct thorough assessments of client needs and develop individualized care plans. +… more
- Molina Healthcare (AZ)
- …policy/procedure development, provider contracting experience. * Experience with NCQA, HEDIS , Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, ... capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease management, and evidence-based guidelines. To all current Molina employees: If you are interested in… more
- CenterWell (Daytona Beach, FL)
- …experience + Experience with Electronic Medical Records (Athena) + Experience with HEDIS + Knowledge of Florida primary care medicine requirements + Working ... knowledge of clinical operations + Excellent customer service + Strong clinical background + Strong sense of engagement to be a team player + Experience in a fast-paced, high-volume environment + Must be passionate about contributing to an organization focused… more
- CenterWell (Mcallen, TX)
- …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 **Work Schedule:** Full Time / 40 Hours / M-F / 8a-5p **Job Type** : Medical Assistant **Specialty** : Primary Care for Seniors **Position Type:** Clinic / On-site **Additional… more
- Aspirus Ironwood Hospital (Wausau, WI)
- …Operations to develop and implement a cohesive Quality Improvement Program that supports NCQA, HEDIS and Medicare Star Ratings. HOURS: Full Time or 1.0 FTE, 80 hours ... every 2 weeks. Experience/Qualifications + 2 years of experience in quality improvement role or 3-5 years of experience in a health care related field preferred. + NCQA accreditation experience is preferred. + Excellent communication skills with ability to… more
- CenterWell (Smyrna, TN)
- …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 **Scheduled Weekly Hours** 40 **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… more
- Elevance Health (Cincinnati, OH)
- …health and wellness programs for federal agencies. + Develop programs to improve HEDIS scores. **Minimum Requirements:** + Requires BA/BS and minimum of 3 years ... clinical experience; or any combination of education and experience, which would provide an equivalent background. + Current, unrestricted RN license in applicable state(s) required. + Multi-state licensure is required if this individual is providing services… more