- Elevance Health (Nashville, TN)
- Anticipated End Date: 2025-08-04 Position Title: Clinical Quality Director - Stars/ HEDIS Job Description: Clinical Quality Director - Stars/ HEDIS ... and quality of life through home-care and community based services. The Clinical Quality Director is responsible for working with the regional head of… more
- Healthmap Solutions (Bowling Green, KY)
- …for better health, for those who need us most. Position Summary The Clinical Care Manager is responsible for developing and maintaining long-term relationships ... Certification (based on role) 3+ years of progressive experience in healthcare services, clinical operations, quality , or care management 3 years of experience… more
- UnitedHealth Group (Sarasota, FL)
- …Nurse, you will function as part of the primary care team, and report to the Clinical Services Manager (CSM). This role works in close collaboration with all of ... activities are delegated by the APC or the team Clinical Services Manager (CSM). The Optum Registered...any other identified stakeholders Review the chart and enter HEDIS / Quality information into the Electronic… more
- EmblemHealth (New York, NY)
- …set priorities and drive value creation that enhances our healthcare clinical value proposition; drive efficient, affordable, and accessible care management and ... issues. Lead projects focused on care management, disease management and quality management optimization, working with stakeholders to identify and execute… more
- AmeriHealth Caritas (Newtown Square, PA)
- **Role Overview** Manages Healthcare Effectiveness Data and Information Set ( HEDIS ) planning, data collection, quality control, analysis, and reporting to meet ... NCQA submission requirements + Ensures all data sent to HEDIS software vendor has Quality Assurance protocols...knowledge and experience in using member, provider, claims, pharmacy, clinical (supplemental) data and hos this data correlates and… more
- Centene Corporation (Salem, OR)
- …of improvement efforts and ongoing performance measures to senior management + Manage all clinical quality metrics and HEDIS processes and results + ... management or healthcare management experience. Advanced working knowledge of HEDIS technical specifications. Quality improvement experience preferred. Master's… more
- Molina Healthcare (TX)
- …National Over read team, National Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. + Mentor ... **C** **E/KNOWLEDGE, SKILLS & ABILITIES:** + 5 years experience in healthcare Quality / HEDIS specific to medical record review and abstraction + Intermediate… more
- Centene Corporation (Phoenix, AZ)
- …and present results of improvement efforts and ongoing performance measures + Coordinate clinical quality metrics and HEDIS processes and results + ... functional process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities + Manager the… more
- ChenMed (St. Louis, MO)
- …with the development and execution of business strategies that increase revenue and quality ratings ( HEDIS /STARS/ Clinical Gaps) and support our core model. ... need great people to join our team. The Center Clinical Manager (CCM) is an active leadership...operations, which may include but is not limited to: clinical quality , compliance, human resources, patient experience… more
- Sanford Health (Sioux Falls, SD)
- …Day Shifts **Job Schedule:** Full time **Weekly Hours:** 40.00 **Job Summary** The Manager works closely with Health Plan providers and staff to coordinate Pharmacy ... Benefit services and promote quality and cost effective outcomes. Interacts with members and...providers to optimize member services. This position supervises the clinical aspects of Health Plan Pharmacy department operations to… more
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