• Clinical Quality and Risk Liaison LVN

    Dignity Health (Bakersfield, CA)
    …years related HEDIS record collection and measures improvement with analytical review /evaluation and / or Quality Improvement. - Experience in data and chart ... Clinical Quality Liaison provides education and acts as a resource for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in… more
    Dignity Health (07/16/25)
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  • Vice President, Enterprise Quality & Process…

    Centene Corporation (Tallahassee, FL)
    …+ Responsible for leading performance improvement initiatives across HEDIS , Stars, State Contract Quality, Pay-for-Performance/Withhold programs, Marketplace QRS, ... Assurance (NCQA) Accreditation and Healthcare Effectiveness Data and Information Set ( HEDIS ) performance ensuring highest level of accreditation + Support the… more
    Centene Corporation (06/28/25)
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  • Data Analyst IV

    Centene Corporation (Austin, TX)
    …of the following areas: claims, provider data, member data, clinical data, HEDIS , pharmacy, external reporting + Extract, load, model, and reconcile large amounts ... of data across multiple system platforms and sources + Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement… more
    Centene Corporation (08/03/25)
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  • Associate Medical Director

    CenterWell (Jacksonville, FL)
    …quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities in care, ensuring clinical assessments ... experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS , meeting local and organizational goals + Personally deliver high-quality primary… more
    CenterWell (07/22/25)
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  • Risk & Quality Performance Manager (Remote)

    Molina Healthcare (Louisville, KY)
    …to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success. * Partner with other teams to ensure data quality ... communicate risks and issues to stakeholders and leadership. * Create, review , and approve program documentation, including plans, reports, and records. *… more
    Molina Healthcare (07/31/25)
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  • LPN or MA Care Manager - Portland or Eugene

    Praxis Health (Portland, OR)
    …+ Coordinate with centralized PXH/Regence teams to drive performance in: + HEDIS metric tracking + Transitional Care Management (TCM) + Annual Wellness Visit ... Ensure high-risk cases are included in the Interdisciplinary Team (IDT) agenda for review 3. High Emergency Room Utilization Oversight + Monitor and manage patients… more
    Praxis Health (07/23/25)
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  • Medication Therapy Management (MTM) Technician

    Prime Therapeutics (Lincoln, NE)
    …to support the Centers for Medicare & Medicaid Services (CMS) Star and HEDIS quality measure programs, including but not limited to: Medication Therapy Management ... qualified members' medications and disease states related to the Star and HEDIS quality measures programs and processes. **Responsibilities** + Receive inbound and… more
    Prime Therapeutics (07/16/25)
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  • MA Quality Performance, Pop Health Boise Clinics…

    Trinity Health (Boise, ID)
    …Quality Performance Improvement initiatives (Gaps In Care Closure) focused on Quality measures ( HEDIS ). + This position will be primarily located at one of our ... PHMA work includes supporting system-wide quality performance goals for HEDIS and STAR measures. This role reports to the...payor lists for open gaps in care, completing chart review for documentation of gap closure, and potentially some… more
    Trinity Health (07/11/25)
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  • Population Health Manager

    Apicha Community Health Center (New York, NY)
    …disparities and social determinants of health. The role encompasses analysis and review of trends and projections of key clinical metrics, supporting new program ... ongoing quality assurance of data and reports, including NCQA PCMH accreditation, HEDIS /QARR, UDS, and HIV Treatment Cascade + Validate data accuracy of Population… more
    Apicha Community Health Center (05/22/25)
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  • Medical Director - Dsnp/MMP

    CVS Health (Tallahassee, FL)
    …of patients with severe, complex, and/or treatment resistant illnesses through peer review and educational interventions. * Work with medical director teams focusing ... on inpatient care management, clinical coverage review , member appeals clinical review ,...multiple stakeholders. * Help achieve or exceed all applicable HEDIS , Stars and local state performance targets and goals… more
    CVS Health (07/18/25)
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