- Molina Healthcare (Everett, WA)
- …regarding quality and HEDIS review and results. + Works with the Manager to monitor accuracy of abstracted records as required by specifications. + Assists the ... the data collected and abstracted from medical records for HEDIS projects, HEDIS like projects and supplemental...off of the audit and chart review. + Assists Manager and Supervisor(s) in leading the training and mentoring… more
- LA Care Health Plan (Los Angeles, CA)
- HEDIS Abstractor II (Temporary) Job Category: Clinical Department: Quality Performance Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... that purpose. Job Summary The Healthcare Effectiveness Data and Information Set ( HEDIS ) Abstractor II reviews medical records to ensure completeness, compliance with… more
- Centene Corporation (Jefferson City, MO)
- …Assurance (NCQA) and Healthcare Effectiveness Data and Information Sets ( HEDIS ) performance improvement projects. + Oversee quality improvement related activities ... (ie outcome studies, QI projects) + Coordinate ongoing data management for HEDIS and QI project management databases. Evaluate sources for alternative data capture,… more
- VNS Health (Manhattan, NY)
- …+ Leads the clinical audit team, ensuring compliance with Medicare STARS, HEDIS /QARR, and regulatory requirements. + Develops forms, record abstracts, reports, and ... accuracy, documentation, and quality reporting to improve STARS and HEDIS scores. + Acts as the primary clinical liaison...for IPAs and provider networks, ensuring alignment with STARS, HEDIS , and clinical quality objectives. + Works closely with… more
- Centene Corporation (Raleigh, NC)
- …and education programs for Plan, provider network, delegated vendors to support NCQA and HEDIS activities. + Develop QI, NCQA and HEDIS projects with delegated ... vendors to support accreditation maintenance and HEDIS reporting. + Coordinate assigned NCQA and ... HEDIS reporting. + Coordinate assigned NCQA and HEDIS work plan activities. + Assist with delegation oversight… more
- Elevance Health (Norfolk, VA)
- ** Manager Business Information** **Location:** This role requires associates to be in-office **3** days per week, fostering collaboration and connectivity, while ... VA; Norfolk, VA; Mason, OH; Cincinnati, OH and Indianapolis, IN The ** Manager Business Information** is responsible for managing a staff of associates whose… more
- Healthfirst (NY)
- …chronic disease management + Assists in writing member and/or provider articles on HEDIS , QARR, Medicare Advantage, and/or health promotions for the HF newsletter + ... LPN, RN, LMSW or LCSW + Multiple years of HEDIS review experience for both Medicaid and Medicare lines...business + Medical record review experience directly working on HEDIS /QARR in a managed care setting + Good presentation,… more
- CenterWell (Dallas, TX)
- …and help us put health first** **Job Profile Summary** The Manager , Stars Improvement, Clinical responsible for the development, implementation and management ... oversight of the Primary Care Organization's clinic-based Stars Program. The Manager , Stars Improvement, Clinical works within specific guidelines and procedures;… more
- Molina Healthcare (Phoenix, AZ)
- …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is responsible for developing, ... implementing, and monitoring the success of quality improvement interventions. The Manager works to coordinate resources and training within the health plan and… more
- Elevance Health (Columbus, GA)
- Value Based Provider Account Manager Sr. (JR150941) **Location:** This role requires associates to be in-office (Atlanta or Columbus/Midland) 1 day per week ... willing to visit providers quarterly. The Value Based **Provider Account Manager Sr.** is responsible for developing and maintaining positive provider relationships… more
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