- Somatus (Mclean, VA)
- …validating HEDIS , medical record reviews_ . Reporting directly to the HEDIS Director , this position will maintain effective communication with internal and ... expert for Policy and Standard Operating Procedures (SOPs) related to HEDIS technical specifications, abstraction, and process intervention. Responsibilities… more
- Elevance Health (Metairie, LA)
- …management skills. + Serves as a resource for the design and evaluation of process improvement plans/quality improvement plans and ensures they meet ... head of quality management to direct the clinical quality initiatives, including HEDIS and CAHPS quality improvement , NCQA accreditation and compliance with… more
- The Cigna Group (Bloomfield, CT)
- …with Cigna's value and mission. + Supports and promotes appropriate team alignment and process improvement work. + Provides coaching and development to teams, in ... **Job Description Summary** The Clinical Program Director sets clinical strategy to drive improvements in health, patient experience, and health disparities. This… more
- Sharp HealthCare (San Diego, CA)
- …conjunction with the Director of PHM/ Medical Management and Quality Improvement Director . + Oversees and mentors Medical Directors and Physician Reviewers. ... programs and work plans. + Assists the Chief Medical Officer and the Quality Improvement Director in creating and maintaining a system that gives feedback to… more
- Highmark Health (Pittsburgh, PA)
- …Drives efficient operational functions to achieve established Quality measures, STARS and HEDIS performance ratings. Directs and manages team of ~75 employees that ... as necessary; may have budgetary responsibility and authority. + Quality Improvement Specialist (QIS) Program:Vision and direction for leading embedded coder/… more
- State of Indiana (Indianapolis, IN)
- …mission. Role Overview: As Assistant Director , you will serve as the Director of Quality Improvement (QI), an integral component in serving Medicaid members. ... delivery. You will oversee managed care entities' (MCE) quality management and improvement functions, HEDIS data and scoring, NCQA Accreditation, Annual Quality… more
- Sharp HealthCare (San Diego, CA)
- …and Chief Medical Officer and reports findings in conjunction with the Quality Improvement Manager. + Participates in the grievance process with the Chief ... in short and long range program planning, total quality management (quality improvement ), and external relationships. Works with all departments of Health Services… more
- Molina Healthcare (FL)
- … activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, ... necessity. + Participates in and maintains the integrity of the appeals process , both internally and externally. Responsible for the investigation of adverse… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical Services area ... medical policies, guidelines and medical criteria. + Assists with training medical director colleagues and nursing staff , including leadership of teaching grand… more
- MVP Health Care (Tarrytown, NY)
- …evaluate and research medical literature is essential + Knowledge of quality improvement including HEDIS , STAR, CAHPS measures is preferred. + Knowledge ... for everyone - which requires innovative thinking and continuous improvement . To achieve this, we're looking for a **Medical.... To achieve this, we're looking for a **Medical Director , Post-Acute Care Utilization Management** to join #TeamMVP. If… more