- Highmark Health (Pittsburgh, PA)
- …and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess the needs of each individual ... or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for collaborative work with other functions… more
- The Cigna Group (Bloomfield, CT)
- …development across clinical roles + Collaborate with leadership to influence clinical quality measures, HEDIS outcomes and continuous improvement ... and customer satisfaction, compliance, quality of care, HEDIS outcomes, and utilization metrics. + Supports Clinical...performance, innovation and patient centricity. + Serves as a clinical consultant and subject matter expert for… more
- Humana (Oviedo, FL)
- …to drive results within a provider network and MSO as it relates to clinical HEDIS measures. + Experience in preparing and delivering training sessions, ... and help us put health first** The Nurse Senior Stars Improvement, Clinical Professional/ Consultant contributes to the development, implementation, and… more
- CVS Health (Oklahoma City, OK)
- …And we do it all with heart, each and every day. **Position Summary** The Quality Management, Nurse Consultant has a key role in developing and implementing ... data-driven strategies/interventions that support the delivery of high quality health benefits and services for members. The QM Consultant coordinates, prepares… more
- CVS Health (Austin, TX)
- …barriers including health disparity and health related social needs, to improve clinical quality , promote best member and provider experience, and ensure ... all with heart, each and every day. **Position Summary** Applies specialized clinical and industry knowledge and performance improvement best practices to quality… more
- CVS Health (Springfield, IL)
- …member program - Clinical license required **Preferred Qualifications** - 2 years HEDIS experience - MBA or masters degree in healthcare or finance related field ... Summary** This role is responsible for managing partnerships with Aetna-Illinois quality vendors and community-based organizations, with the primary focus to improve… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- …healthcare standards and measures such as Healthcare Effectiveness Data and Information Set ( HEDIS ), National Quality Forum (NQF), and Adult and Child Heath ... Nurse Consultant (General) (40 Hour) Hybrid Recruitment # 251021-5927FP-001...you to lead groundbreaking healthcare initiatives that drive program quality , enhance community health, and promote social justice. We… more
- Elevance Health (FL)
- …Carelon Health is a proud member of the Elevance Health family of brands, offering clinical programs and primary care options for seniors. We are a team of committed ... the Possibilities. Make an Extraordinary Impact.** **Title** : OB Practice Consultant **Virtual:** This role enables associates to work virtually full-time, with… more
- ChenMed (Houston, TX)
- …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
- LA Care Health Plan (Los Angeles, CA)
- …Minimum of 4 years of Health Services Domain experience required. 3 years of Clinical Care and 3 years of HIE, HEDIS experience preferred. Functional knowledge ... the right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents… more
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