• Lead Director - Quality

    CVS Health (RI)
    …will do** + Lead team of experienced analysts in support of HEDIS and other quality measure performance forecasting (ARIMA, exponential smoothing, regression ... And we do it all with heart, each and every day. Leads quality measure focused forecasting analytics and tableau dashboard team. Administers quality more
    CVS Health (10/08/25)
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  • Director Risk Adjustment, Coding…

    Highmark Health (Pittsburgh, PA)
    …state and federal levels. Drives efficient operational functions to achieve established Quality measures, STARS and HEDIS performance ratings. Directs and ... ensure complete / accurate assessment and documentation of member profile. + HEDIS Abstraction:Primary liaison with Highmark's Quality / Stars team for retrieval… more
    Highmark Health (08/08/25)
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  • Senior Medical Director - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …+ Responsible and accountable for implementing the Utilization/Cost Management Program and Quality Improvement Program, in conjunction with the Director of PHM/ ... health care needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical...Medical Management and Quality Improvement Director . + Oversees and mentors Medical Directors and Physician… more
    Sharp HealthCare (07/19/25)
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  • Center Medical Director

    ChenMed (Warren, MI)
    …position towards becoming a center clinical P&L leader (ie, Senior Medical Director [SMD]) in the organization. The incumbent Center Medical Director ... may be simultaneously completing PCP Black Belt Training and Mastering the Medical Director Essentials within a combined and accelerated PCP and medical director more
    ChenMed (09/20/25)
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  • Center Clinical Director

    ChenMed (Houston, TX)
    …position towards becoming a center clinical P&L leader (ie, Senior Medical Director [SMD]) in the organization. The incumbent Center Medical Director ... may be simultaneously completing PCP Black Belt Training and Mastering the Medical Director Essentials within a combined and accelerated PCP and medical director more
    ChenMed (10/03/25)
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  • Senior Director , Quality

    Centene Corporation (New York, NY)
    …in the Northeast with occasional travel to Bedford, NH!** **Position Purpose:** Lead and direct process improvement activities that provide more efficient and ... streamlined workflow. + Responsible for National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set (… more
    Centene Corporation (10/04/25)
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  • Associate Center Clinical Director

    ChenMed (Margate, FL)
    …Manages clinical teams to deliver VIP service, standards of care and quality guidelines, HEDIS /STARS, high-risk disease detection and high-risk disease ... rapidly expanding and we need great people to join our team. The Medical Director , Center is specifically responsible for executing the ChenMed Way and core model in… more
    ChenMed (09/09/25)
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  • Medical Director , Commercial Line…

    Excellus BlueCross BlueShield (Rochester, NY)
    …management, decision-making, and problem-solving skills. + Knowledge of credentialing, quality , NCQA/ HEDIS /CMS and/or Medicaid Star Ratings, and/or value-based ... is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical Services area… more
    Excellus BlueCross BlueShield (09/30/25)
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  • VP or Director of Strategic Accounts

    Drips (OH)
    Position Title: VP or Director of Strategic Accounts Location: Remote Reports To: SVP of Healthcare Solutions Type: Full Time | High Impact | Quota-Carrying About ... journey, helping national, regional, and local health plans improve Stars, HEDIS , HOS, Medication Adherence, acquisition, and retention strategies. Our work in… more
    Drips (09/23/25)
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  • Medical Director (Based in Idaho)

    Molina Healthcare (Idaho City, ID)
    …clinical quality improvement activity (QIA) in collaboration with the clinical lead , the medical director , and quality improvement staff. + ... action plan, which includes strategies that ensure a high quality of patient care, ensuring that patients receive the...including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge.… more
    Molina Healthcare (10/03/25)
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