- Essentia Health (Duluth, MN)
- **Job Description:** The Program Manager - Cardiometabolic Diseases develops, implements and coordinates the cardiometabolic program aimed at managing and improving ... Heart & Vascular Division and related specialties. The program manager will also help optimize access and streamline care...Epic EHR, clinical registries, and payer quality initiatives (eg, HEDIS , MIPS) + Knowledge of rural health challenges and… more
- Banner Health (AZ)
- …3. Monitors and tracks Corrective Active Plans (CAPs), in collaboration with the Manager , Supervisor or QM RN and communicates audit results to providers along with ... compliance issues identified in the audit process to the Manager /Supervisor of QM. Assists in the development of QM...analysis of data from medical records in accordance with HEDIS specifications. Actively works with the HEDIS … more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Case Management staff, members, and providers. + Provides backup for the Supervisor/ Manager , whenever necessary by: + Participating in the orientation of new staff ... 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… more
- CDPHP (Latham, NY)
- …Case Management staff, members, and providers. + Provides backup for the Supervisor/ Manager , whenever necessary by: + Participating in the orientation of new staff ... 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… 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:** ... care models. **_ _** **Position Purpose:** The Regional Provider Engagement Manager will support provider performance and engagement efforts within a specific… more
- CVS Health (Albany, NY)
- …new and exciting ways every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products in ... sales, marketing, provider relations, network development, utilization management, and/or STARS/ HEDIS quality improvement, and Revenue Integrity efforts. Coordinating and… more
- Molina Healthcare (Spokane, WA)
- **Job Summary** The Manager , Medical Economics provides support and consultation to the New York Health Plan and Finance team through analyzing key business issues ... sources. + Knowledge of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare… more
- Molina Healthcare (WA)
- **JOB DESCRIPTION** **Job Summary** The Regional Manager Value Based Programs plays a critical role in the development and implementation of value-based programs and ... Knowledge of value based programs, risk adjustment models, quality metrics such as HEDIS and STARS, knowledge of coding + Knowledge of medical economics and… more
- CenterWell (Jacksonville, FL)
- …to achieve optimal patient outcomes and company initiatives, including Quality, HEDIS /STARs, AHCA, financial management, and employee and patient retention. Specific ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
- Vatica Health (Springfield, MA)
- The Provider Engagement Manager (PEM I), is an integral role at Vatica, responsible for overall practice success, including but not limited to provider satisfaction, ... BI (Preferred) + Strong knowledge/experience with Quality, Risk Adjustment and Medicare HEDIS /Stars Programs (Preferred) + Experience working in a CRM such as… more