• Senior Specialist, Member & Community…

    Molina Healthcare (OH)
    …skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis, and/or ... intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions… more
    Molina Healthcare (10/19/25)
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  • Provider Relations Senior Manager,…

    CVS Health (Chicago, IL)
    …compliance within our network responsibilities as provided within the state Medicaid contractual requirements. This position holds a variety of functions for ... streamline, policies, procedures, provider interactions/trainings and optimize workflows. + Data & Insights Utilization: Leverage analytics to identify trends,… more
    CVS Health (11/01/25)
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  • Senior Data Analyst

    Fair Haven Community Health Care (New Haven, CT)
    …(Epic/Clarity/Caboodle, eClinicalWorks, NextGen, Athena, etc.) and/or claims data ( Medicaid /Medicare/commercial). + Working knowledge of eCQMs, UDS, HEDIS , ... care, regardless of ability to pay. Job purpose The Senior Data Analyst turns clinical, operational, and...maintain dashboards and reports for clinical quality (ex. UDS, HEDIS ), operations, regulatory, revenue cycle, and VBC performance. +… more
    Fair Haven Community Health Care (10/30/25)
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  • Quality Improvement Senior Clinical…

    Humana (Stuart, FL)
    …caring community and help us put health first** The Quality Improvement Senior Clinical Professional (RN) is responsible for the development, implementation and ... Beach, Stuart, Jupiter - Treasure Coast/Palm Beach Market). The Quality Improvement Senior Clinical Professional (RN) develops programs designed to increase the plan… more
    Humana (10/28/25)
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  • Senior Analyst, Medical Economics (Vbc)…

    Molina Healthcare (NY)
    **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... creating tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex analyses of… more
    Molina Healthcare (08/31/25)
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  • Senior Network Performance Professional

    Humana (Richmond, VA)
    …a part of our caring community and help us put health first** As a Senior Network Performance Professional at Humana, you will play a pivotal role in enhancing ... and monitor performance toward these goals + Actively monitors and analyzes provider performance data to identify areas for improvement + Serves as an expert on the… more
    Humana (11/01/25)
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  • Senior Quality Specialist

    Trinity Health (Boise, ID)
    …in data analysis, preferably in health care. + **Experience with HEDIS (Healthcare Effectiveness Data and Information Set), PQRS (Physician Quality Reporting ... **Employment Type:** Full time **Shift:** Day Shift **Description:** ** SENIOR QUALITY SPECIALIST** **SUMMARY:** The Senior Quality Specialist is responsible for… more
    Trinity Health (10/30/25)
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  • Nurse Case Manager - Senior Care Options…

    Fallon Health (Barnstable, MA)
    …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... and nursing assessment skills, may complete NaviCare Program Assessment Tools and Minimum Data Set Home Care (MDS HC) Form when a member's medical/functional status… more
    Fallon Health (10/28/25)
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  • Senior Specialist, Quality Interventions/QI…

    Molina Healthcare (Chicago, IL)
    …**Preferred Experience** + 1 year of experience in Medicare and in Medicaid . + Experience with data reporting, analysis and/or interpretation. **Preferred ... programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities;… more
    Molina Healthcare (10/18/25)
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  • Stars Technology Business Intelligence Lead…

    Humana (Bismarck, ND)
    …and HEDIS quality measures. The ideal candidate has deep expertise in Stars/ HEDIS data , regulatory requirements, and agile product development, and 3 tier ... Define and maintain the vision, strategy, and roadmap for data products that enable CMS Stars and HEDIS...projects or programs + Proficiency in understanding Healthcare related data + Proficiency in verbal/written communication to senior more
    Humana (11/01/25)
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