- Elevance Health (Norfolk, VA)
- …technical problems both independently and collaboratively, with a focus on supporting Quality and Clinical initiatives. + Effective communication skills are ... **Business Information Consultant ** **Location:** This role requires associates to be...Preference will be given to candidates with experience in HEDIS / Quality measures data analytics. Please be advised… more
- ChenMed (St. Petersburg, FL)
- …overall clinical value while engaging physicians to improve clinical quality , efficiency, outcomes, cost effectiveness, and physician/patient satisfaction. ... days), CG CAHPS and net promoter score (patient experience), HEDIS and clinical gaps closures, and medical...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other… more
- ChenMed (Decatur, GA)
- …indicators. + Fosters growth and effectiveness of Pharmacy work teams to meet quality and clinical care standards/ + Assists Pharmacy leadership in ensuring ... rapidly expanding and we need great people to join our team. The Clinical Pharmacist specializing in Population Health is a skilled and proactive professional who… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …require peer-to-peer discussions with providers regarding UM case review determinations. + Provides clinical expertise on ARD cases, Quality of Care cases, ... Level I Accountabilities) + Leads, develops, directs and implements clinical and non- clinical activities that impact health care quality cost and outcomes. +… more
- Covenant Health Inc. (Knoxville, TN)
- …the patient care setting, coordinating education of staff and patients and serving as a clinical resource and consultant to the health care team. The RN Care ... through the collaborative development of practice guidelines and clinical pathways that support quality improvement activities....care. + Stays abreast of most recent changes in quality related to HEDIS measures, CMS Conditions… more
- ChenMed (Richmond, VA)
- …count for 2 slots, follow-up patients, typical 1.0 PCP FTE slots are 18-21), HEDIS >4, CG CAHPS (patient experience), clinical gaps closures, and medical cost ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other… more
- VNS Health (Manhattan, NY)
- …consultant for unusual and difficult medical cases. Participates in the QARR/ HEDIS Quality Improvement Activities and utilization management of the ... health enhancement programs that support the appropriate use of clinical resources in the delivery of consistent high- quality... clinical resources in the delivery of consistent high- quality medical care. + Performs clinical reviews… more
- Sharp HealthCare (San Diego, CA)
- …(NCQA); AlignMeasurePerform (AMP); Pay for Performance (P4P) metrics; Medicare Stars; HEDIS ; Performance Guarantees and metrics; and other quality measurement ... of strategic plans. In a multidisciplinary approach, functions as clinical expert, consultant , educator, researcher/evaluator. Supports senior leadership… more
- ERP International (Barksdale AFB, LA)
- …care through a continuum facilitating the achievement of optimal outcomes in clinical , quality and cost-effectiveness arenas. Provides direct clinical ... most cases a referral to the Internal Behavioral Health Consultant (IBHC) in Primary Care is appropriate for an...to change. Possesses knowledge of disease management programs and clinical practice guidelines (eg VA/DoD CPGs), and HEDIS… more
- CenterWell (Dallas, TX)
- …relationship environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding ... and provide medical direction in pursuit of cost effective, quality healthcare. + Plan, organize, manage and supervise the...in the state of desired employment + Experience leading clinical practice operations + Demonstrate a high level of… more
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