- CenterWell (Zephyrhills, FL)
- …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 **Use your skills to make an impact** **Additional Information:**… more
- Veterans Affairs, Veterans Health Administration (Palo Alto, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... successful attainment of clinical performance measures affecting the SAIL and HEDIS measures. Ensures accountability among staff in meeting performance standards by… more
- ERP International (Camp Pendleton, CA)
- …Military Health System beneficiaries. Including, but not limited to, all command specific HEDIS metrics. * Track metrics of success as informed by command for ... as needed. * Assist the PHP Project Manager/Senior Strategist in the review , development, and implementation of policies, procedures, processes, and guidelines. *… more
- CenterWell (Independence, MO)
- …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 + annual bonus. .… more
- CenterWell (San Antonio, TX)
- …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 **Additional Information:** + Guaranteed base salary + bi-annual… more
- CenterWell (Las Vegas, NV)
- …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 + Bilingual English/Spanish. Must be able to speak, read… more
- Centene Corporation (Sacramento, CA)
- …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… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …algorithms. + Recommend appropriate interventions to meet accreditation requirements (NCQA, HEDIS , etc.). + Support the Specialty Pharmacy management program by ... them to drug utilization management, care management activities, product review , and program development. **What you'll bring:** **Required Qualifications** +… more
- ChenMed (Margate, FL)
- …PCPs are keeping in contact with hospitalized patients and hospitalists; facilitates review of inpatients and other high priority patients during super huddle, ... teams to deliver VIP service, standards of care and quality guidelines, HEDIS /STARS, high-risk disease detection and high-risk disease management and other evidence… more
- Sanford Health (Sioux Falls, SD)
- …strategic initiatives. Knowledgeable of governing bodies, budgeting, accreditation, and contracts. Review and consult on final strategic plans in collaboration with ... is required. Management, leadership, Healthcare Effectiveness Data and Information Set ( HEDIS ), and accreditation is preferred. Minimum of 5 years nursing experience… more