- Monogram Health (Fort Myers, FL)
- …Medicare Advantage and managed Medicaid populations Experience with NCQA, HEDIS , Medicaid, Medicare, quality improvement, medical utilization management, and risk ... adjustment Current state medical license without restrictions to practice and free of sanctions from Medicaid or Medicare. Willingness to become licensed in multiple states. MD (Medical Doctor) or DO degree from an accredited medical school BC or BE in an… more
- Sanitas Medical Center (Fort Lauderdale, FL)
- …and evaluate physicians, nurse practitioners, and physician assistants. Ensure completion of HEDIS and quality metrics, appropriate risk adjustment coding , and care ... coordination. Oversee performance improvement initiatives and participate in peer review processes. Support recruitment, onboarding, and professional development of medical providers. Maintain compliance with OSHA, ACHA, infection control , and emergency… more
- Universal Health Services, Inc. (Edinburg, TX)
- …referral network Support our Physicians to complete Value Based Care and HEDIS Measures. Support patients via in-Person consult, Telemedicine visits, and sponsored ... health events. Champion a comprehensive, coordinated model of care for Medicare-aged population on a Medicare Advantage Plan and Medicaid population. Champions the Attestation process by collaborating with STHS physicians, managed care resources, and STHS… more
- HarmonyCares (Euless, TX)
- …and identify areas for improvement leading to superior Quality ( HEDIS ) performance Frequently review clinician capacity and productivity performance. Partner ... with Site Medical Directors to develop countermeasures and support their implementation when provides are off track Work collaboratively with Regional Medical Director (RMD) to identify opportunities for care improvement Assists with service inquiry,… more
- Centene Corporation (Springfield, IL)
- …that meets directly with provider groups based in the Chicago area to discuss HEDIS performance and strategize ways to improve performance, up to 75% travel. Typical ... provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures,… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Sr. HEDIS Coordinator position in the Quality Improvement department. This is a full time position working Monday ... Pittsburgh or surrounding area to be considered! The Sr. HEDIS Coordinator will assists with the management of ...HEDIS Coordinator will assists with the management of HEDIS Coordinator activities in addition to performing the day-to-day… more
- Humana (Little Rock, AR)
- …demonstrate expertise and business intelligence in supporting execution of the HEDIS program and related activities, all within tightly regulated requirements and ... Compliance, and Risk Adjustment, as well as vended partners. The Senior HEDIS Operations & Quality Professional supports all aspects of the non-standard supplemental… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a HEDIS Coordinator position in the Quality Improvement department. This is a full time position working Monday ... Application from network physicians and Health Plan staff, to support for HEDIS measure compliance or potential measure exclusion. Responsibilities: + Adhere to the… more
- Providence (CA)
- …empower them._** **Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:** + Be responsible for conducting clinical quality audits/overreads ... to determine potential areas for quality improvement within the HEDIS project + Collect data by way of chart...specifications for the Healthcare Effectiveness and Data Information Set ( HEDIS ) program + Conduct Audits inclusive of review of… more
- Molina Healthcare (TX)
- …Quality Reporting team. Designs and develops reporting solutions to assist HEDIS Outbound, Inbound extracts, Data Ingestions, Dashboards, Reports & Extracts for ... Experience** * 5+ Years of experience in working with ** HEDIS ** tools such as **Inovalon** or **ClaimSphere** * 5+...**ClaimSphere** * 5+ Years of experience in working with HEDIS Domain - such as Measure analysis/reconciliation on data… more
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