- Somatus (Mclean, VA)
- …physical and mental well-being + Community engagement opportunities + And more! The Clinical HEDIS Coordinator I will perform the functions related to the ... be to analyze and process the information collected and review the applicable medical records and clinical ...programs. + Interface with data support, quality assurance team, HEDIS Quality Manager , and IT to collect… more
- Molina Healthcare (Bowling Green, KY)
- …Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. + Mentor entry and Sr. level abstractors. + Works ... lead role in the coordination and preparation of the HEDIS medical record review which includes ongoing...vendors for the medical record collection process. + Assists Manager and Supervisor(s) in training, utilizing the standardized training… more
- Highmark Health (Harrisburg, PA)
- …+ None **Preferred** + Pharmacy **EXPERIENCE** **Required** + 3 years of clinical pharmacy management experience including drug use review activities, ... **JOB SUMMARY** This job will be accountable for the clinical pharmacy operations area, specifically the clinical ...+ Experience with regulatory entities such as CMS, NCQA, HEDIS , DOH etc. **Preferred** + None **LICENSES or CERTIFICATIONS**… more
- Elevance Health (Miami, FL)
- …knowledge of ICD-10 CM, CMS guidelines including Risk Adjustment payment model, STARS and HEDIS highly preferred. + Clinical review experience. Please be ... of goals and workflows to support value capture initiatives and high-quality clinical documentation. + Chart reviews for closing HEDIS care opportunities… more
- Dignity Health (Phoenix, AZ)
- … teams within Arizona Care Network (ACN). ACN CPLs report to the Manager of Practice Transformation within the Clinical Performance Department, and are ... and is a Dignity Health and Abrazo Health (Tenet) physician collaboration. The Clinical Performance Liaison (CPL) is an employee of Arizona Care Network, doing… more
- Molina Healthcare (Augusta, GA)
- …requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug ... regimen review , patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient outcomes,… more
- Community Health Systems (Naples, FL)
- …of Nursing, ASN required or + Bachelor's Degree BSN required + 2-4 years clinical practice experience required + Experience in HEDIS , MIPS, PQRS, ACO, STARS ... **Job Summary** Under the direction of the UR Director/ Manager the UR Nurse reviews all admissions for...programs + Addresses facility and departmental communication through daily review of all correspondence, including incoming email messages. +… more
- Robert Half Finance & Accounting (Shrewsbury, MA)
- Description The Revenue Cycle Manager is responsible for overseeing and optimizing the end-to-end revenue cycle processes, a Federally Qualified Health Center (FQHC) ... standards, KPIs, and SLAs related to vendor performance. * Review and escalate vendor issues that impact cash flow...* Analyze claims data and suggest/implement procedures to maximize UDS/ HEDIS and incentive revenue collections (ie, ICD-10 and CPT… more
- Elevance Health (Metairie, LA)
- …for working with the regional head of quality management to direct the clinical quality initiatives, including HEDIS and CAHPS quality improvement, NCQA ... in developing, monitoring, and evaluating Healthcare Effectiveness Data Information Set ( HEDIS ) improvement action plans, year-round medical record review , and… more
- CenterWell (Jacksonville, FL)
- …leading clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts ... indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS , meeting local and organizational goals +… more
Related Job Searches:
Clinical,
Clinical Review,
HEDIS,
HEDIS Manager,
Manager,
Manager Clinical Review,
Review