- CenterWell (Sun City, AZ)
- …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 is a plus. **Additional Information** + Guaranteed… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. ... 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
- Novant Health (NC)
- …of the nation's 150 Best Places to Work in Healthcare by Becker's Hospital Review + Recognized as Leaders in LGBTQ+ Healthcare Equality by the Human Rights Campaign ... can apply knowledge of generally accepted accounting principles, patient attribution, HEDIS and other quality details, and federal and state regulatory requirements;… more
- CenterWell (Callahan, 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 . Bilingual (English and Spanish) is a plus **Additional… more
- Guidehouse (Atlanta, GA)
- …subject matter expert support across multiple client engagements; develop and review presentations, briefings, and memos, and reports. Identify client needs and ... + Experience with commercial health datasets, eg, claims, encounters, risk scoring, HEDIS measures, etc. + Knowledge of recent and ongoing public health initiatives… more
- Martin's Point Health Care (Portland, ME)
- …regulatory standards (eg NCQA, CMS, TRICARE) + Participates in medical policy review and policy development. + Works with Informatics, Network Management, and ... days/1000, SNF days/1000, and clinical quality improvement (QI) objectives, including HEDIS and how to drive improvement in these areas Education/Experience: +… more
- CenterWell (Deerfield 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 (Fort Lauderdale, 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
- 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
- ChenMed (Berwyn, IL)
- …use, improve patient outcomes, and enhance CMS Star Ratings and HEDIS quality measures. This position requires advanced clinical judgment, effective patient ... diabetes, hypertension, cholesterol) and other high-priority therapeutic areas. + Review and verify prescriptions and medication order for appropriateness, including… more