• Sr . Provider Engagement Account…

    Centene Corporation (Tampa, FL)
    …performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Present detailed HBR analysis and ... relations, quality improvement, claims, contracting, utilization management, or clinical operations. Project management experience at a medical group, IPA, or health… more
    Centene Corporation (05/08/25)
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  • Sr . Specialist, Member & Community…

    Molina Healthcare (Dallas, TX)
    **Job Description** **Job Summary** The Sr Specialist, Member & Community Interventions oversees and implements new and existing clinical quality member intervention ... Duties** + Acts as a lead specialist to provide project , program, and/or initiative related direction and guidance for...to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may… more
    Molina Healthcare (06/19/25)
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  • Behavioral Health Clinical Quality Audit Analyst…

    Elevance Health (Seven Fields, PA)
    **JR152864 Behavioral Health Clinical Quality Audit Analyst Sr ** This role is primarily focused on conducting medical record reviews of facilities and clinics in our ... quarterly, annual and ad hoc medical record reviews such as ASAM monitoring, HEDIS and Clinical Practice Guideline (CPG) compliance. + Coordinates site visit dates… more
    Elevance Health (06/17/25)
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  • Senior Manager , Project

    CVS Health (Alpharetta, GA)
    …we do it all with heart, each and every day. **Position Summary** As a Senior Manager , you will be part of the Clinical Platform Solutions Interoperability team ... you will drive system projects and initiatives with emphasis on HEDIS bi-directional data exchange, clinical platform interoperability, technical enablement, and… more
    CVS Health (06/26/25)
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  • Senior Client Coding Project

    Datavant (Providence, RI)
    …educational and life experiences to realize our bold vision for healthcare. As a Sr . Client Coding Project Manager , you will plan, forecast, and ... phase of client projects and ensure all parties remain on track with project requirements, deadlines, and schedules. **You will:** + Partner with Customer Success… more
    Datavant (06/28/25)
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  • Senior Risk & Quality Performance…

    Molina Healthcare (Caldwell, ID)
    **Job Description** **Job Summary** The Sr Risk & Quality Performance Manager is a tactical execution role that will lead specific projects to support Molina's ... and gain their trust and respect. * Resolve complex problems through project management, data analytics, and stakeholder collaboration. * Manage program changes and… more
    Molina Healthcare (06/26/25)
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  • Health Care Quality Senior Manager

    CVS Health (Atlanta, GA)
    …plans . Evaluates and prioritizes recommendations for quality improvement to senior health plan management . Develops and implements the infrastructure of ... + Aggregative Performance Improvement Projects meeting "pass" criteria Performance tracking for HEDIS measures + Triple weighted + MTMM + MTTMM+ Triple weighted by… more
    CVS Health (06/28/25)
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  • Technical Applications Manager II

    LA Care Health Plan (Los Angeles, CA)
    …purpose. Job Summary The Technical Application Manager II reports to the Senior Manager Information Technology IT Solutions Delivery. This role acts as the ... Technical Applications Manager II Job Category: Information Technology Department: IT...Act as liaison between IT Solution Delivery team and Program/ Project Managers for all Enterprise Initiatives. Manage and prioritize… more
    LA Care Health Plan (06/10/25)
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  • Manager , Health Plan Quality Interventions…

    Molina Healthcare (OH)
    …and leads the interventions Joint Operations Committee representing the Molina Plan Senior Leadership Team. In all activities, the Manager works with ... accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is responsible for developing,… more
    Molina Healthcare (06/15/25)
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  • Public Health Educator/Health Promotion…

    ERP International (Camp Pendleton, CA)
    …and strengthen the awareness of available electronic resources. * Collaborate with PHP Project Manager / Senior Strategist to construct an annual strategic ... beneficiaries. Including, but not limited to, all command specific HEDIS metrics. * Track metrics of success as informed...posters, flyers, and social media. * Collaborate with PHP Project Manager / Senior Strategist to periodically… more
    ERP International (05/21/25)
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