- Premera Blue Cross (Mountlake Terrace, WA)
- …compliance, and cost-effective, clinically sound drug coverage decisions. + Continuously review and adapt to regulatory and accreditation requirements (ACA, WA OIC, ... AK DOI, NCQA, HEDIS ). Support medical management and clinical pharmacy initiatives through...them to drug utilization management, care management activities, product review , and program development. **What you will bring** :… more
- General Dynamics Information Technology (Falls Church, VA)
- …knowledge of Joint Commission standards, Infection Control and other quality measures. + Review raw and synthesized data ( HEDIS , ORYX, TJC, NPIC, NSQIP, AHRQ ... and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and… more
- ERP International (Barksdale AFB, LA)
- …to determine deployment status in a private setting. + Conduct pre-deployment review of health record for any conditions that may impact deployment status. ... + Review the Electronic Health Record (EHR) to identify current...programs and clinical practice guidelines (eg VA/DoD CPGs), and HEDIS Measurements. + Teaches patients and family member's ways… more
- Adelante (Buckeye, AZ)
- …electronic health record. Clinical Collaboration + Collaborate with the clinical team to review and act on Tasks/PTAs sent by providers. + Collaborate with the FM/IM ... as needed per AHC standing orders and procedure. + Review and contact patients regarding normal & abnormal labs...and closure of Healthcare Effectiveness Data & Information Set ( HEDIS ) care gaps of required Quality Metrics. + Coordinate… more
- Datavant (Indianapolis, IN)
- …+ Previous Medicare Advantage Risk Adjustment, CDI, Medicaid, Commercial RA, and HEDIS experience. + Familiarity with HIPAA patient privacy requirements. + Excellent ... protected status. To learn more about our commitment, please review our EEO Commitment Statement here (https://www.datavant.com/eeo-commitment-statement) . Know Your… more
- CenterWell (Tallahassee, FL)
- …defined by Clinical Leadership. + Meets with RMD about quality of care, review of outcome data, policy, procedure, and records issues. + Participates in potential ... of Medicare guidelines and coverage. + Bilingual is a plus + Knowledge of HEDIS quality indicators. Travel: While this is a remote position, occasional travel to… more
- CenterWell (Indianapolis, IN)
- …defined by Clinical Leadership. + Meets with RMD about quality of care, review of outcome data, policy, procedure, and records issues. + Participates in potential ... environment + Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality indicators **Compensation & Benefits** + Competitive base salary + annual… more
- CenterWell (Daytona Beach, FL)
- …defined by Clinical Leadership. . Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues. . Participates in potential ... Medicare guidelines and coverage . Bilingual is a plus . Knowledge of HEDIS quality indicators **Additional Information:** . Guaranteed base salary + quarterly bonus… more
- CenterWell (Spartanburg, SC)
- …defined by Clinical Leadership. + Meets with RMD about quality of care, review of outcome data, policy, procedure, and records issues. + Participates in potential ... + Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality indicators **Additional Information** **Why CenterWell Senior Primary Care** Humana… more
- University of Rochester (Rochester, NY)
- …data analytics to evaluate performance with PCMH requirements, including a retrospective review of electronic medical records and data. + Performs rigorous data ... for submission of PCMH. + Participate in reviewing reports to ensure alignment with HEDIS and CMS metric definitions to meet PCMH requirements. + Works closely with… more