• Quality Programs Measurement Analytics…

    Excellus BlueCross BlueShield (Dewitt, NY)
    …all lines of business. Incumbents have the responsibility to understand HEDIS /CAHPS, Quality Assurance Reporting Requirements (QARR), Quality Rating System (QRS) ... along with influencing the Health Plan's quality ratings performance. The consultant monitors trends, outcomes and business processes using data mining techniques,… more
    Excellus BlueCross BlueShield (07/01/25)
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  • Quality Management, Nurse Consultant

    CVS Health (Springfield, IL)
    …quality strategy and ABHIL population health model. The Quality Management, Nurse Consultant directs analysis and reporting of member and provider data to monitor ... and evaluates targeted member/provider initiatives and supports the development of HEDIS interventions and initiatives within the Quality Management Team. - Reviews… more
    CVS Health (06/27/25)
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  • Sr. Analytics Consultant | Remote…

    Two95 International Inc. (New York, NY)
    Job Title: Sr. Analytics Consultant Job type : Remote Work Type : 6+ Months Contract with extension Rate : $Market /Hour Requirements Job Description: Primary ... Python and R, or similar * Deep familiarity with HEDIS & CMS care quality measures; experience implementing both... & CMS care quality measures; experience implementing both HEDIS and CMS measures using SAS and/or SQL *… more
    Two95 International Inc. (06/09/25)
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  • Business Information Consultant (Health…

    Elevance Health (FL)
    **Business Information Consultant (Health Economics)** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... OH; Cincinnati, OH and Norfolk, VA. The **Business Information Consultant (Health Economics)** is responsible for serving as an...and/or medical claims is strongly preferred. + Knowledge of HEDIS and STARS (quality metrics) as well as medication… more
    Elevance Health (07/01/25)
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  • Quality Management, Nurse Consultant

    CVS Health (Oklahoma City, OK)
    …each and every day. **Position Summary** The Quality Management, Nurse Consultant has a key role in developing and implementing data-driven strategies/interventions ... high quality health benefits and services for members. The QM Consultant coordinates, prepares and delivers committee reports, reviews documentation and interprets… more
    CVS Health (06/27/25)
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  • OB Practice Consultant

    Elevance Health (Topeka, KS)
    …Must be located in the state of Kansas. The **OB Practice Consultant ** is responsible for fostering partnerships with healthcare providers and key Health ... practice patterns, assets and challenges utilizing Medical Home Index, NCQA Standards, HEDIS audits, site reviews and medical records reviews. + In partnership with… more
    Elevance Health (07/01/25)
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  • Technical Applications Manager II

    LA Care Health Plan (Los Angeles, CA)
    …needs; this plan includes Application Roadmaps, Staffing Model (FTE and Consultant ), SOA Service Definition, Data Management/Interfaces. This position works closely ... At least 4 years of IT Vendor (Software and Consultant ) Management. Preferred: At least 3 years of Production...years of Clinical Care and 3 years of HIE, HEDIS experience preferred. Functional knowledge of HEDIS ,… more
    LA Care Health Plan (07/08/25)
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  • Medical Director, Commercial Line of Business

    Excellus BlueCross BlueShield (Rochester, NY)
    …and divisional meetings, including in person meetings. + Serves as a resource and consultant to other areas of the company. + May be required to represent the ... the utilization management program policies and procedures. + Serves as a resource and consultant to other areas of the company. + Assists in many aspects of… more
    Excellus BlueCross BlueShield (07/01/25)
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  • Associate Center Clinical Director

    ChenMed (St. Petersburg, FL)
    …hospital sick days), CG CAHPS and net promoter score (patient experience), HEDIS and clinical gaps closures, and medical cost effectiveness measures. Each primary ... **Coaching for health** : Act as a health coach, rather than just a consultant for sickness, by helping patients set short and long-term health goals, partners with… more
    ChenMed (07/12/25)
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  • Healthcare Analyst

    Beth Israel Lahey Health (Wakefield, MA)
    …trend mitigations. + Serves as analytical resource and internal consultant for organization's multidisciplinary quality and utilization improvement initiatives. + ... including medical terminology and standard coding systems (ICD9, ICD10, CPT, MS-DRG, etc.), HEDIS . **As a health care organization, we have a responsibility to do… more
    Beth Israel Lahey Health (07/12/25)
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