- 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 (Richmond, VA)
- …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
- 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
- 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
- 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