- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Pharmacy Stars Improvement Lead will be a part of a collaborative Pharmacy ... is accountable for Humana's Stars patient safety measure performance. The Pharmacy Stars Improvement Lead will autonomously develops, implements, and… more
- CVS Health (St. Louis Park, MN)
- …**Position Summary** As the **Senior Manager of Stars ** , you will lead the market-wide strategy, performance improvement , and execution of the Medicare ... + Collaborate with internal teams (HEDIS, Clinical Operations, Network, Pharmacy , Product, Member Experience, Data/Analytics, Compliance) to implement evidence-based… more
- CenterWell (Houston, TX)
- …of our caring community and help us put health first** The Quality Improvement Professional 1 will support clinicians and staff, working collaboratively with the ... Stars Clinical Quality RN/s, to support staffed clinical and...Provide support, make recommendations and assist with implementing quality improvement best practice initiatives designed to improve Medicare quality… more
- CVS Health (Tallahassee, FL)
- …Advantage members' adherence to select maintenance medications informs health plans' Medicare Stars quality rating and may lead to better health outcomes. ... more compassionate. And we do it all with heart, each and every day. ** Pharmacy Technician, Aetna Medicare - Work From Home** **(Aetna Medicare Pharmacy … more
- Aspirus Ironwood Hospital (Wausau, WI)
- … pharmacy ), appeals, medical policy (development and maintenance), and quality improvement (Medicare Stars , NCQA). The Medical Director ensures that Aspirus ... is responsible for conducting day-to-day medical management and leading ongoing improvement initiatives in collaboration with the Director of Operations, Quality … more
- CommonSpirit Health (Phoenix, AZ)
- …of platforms used for care coordination, risk stratification, quality improvement , and payer-provider integration, ensuring alignment with the organization's ... and commercial managed care contracts. Essential Functions: Systems Strategy & Leadership Lead the design and implementation of IT systems that support managed care… more
- Mount Sinai Health System (New York, NY)
- …System. Serves as mentor to others in the Data Science team and takes the lead role in project initiatives. **Qualifications** + BA or BS degree minimum, in a ... State Medicaid and CMS Medicare regulations and related reporting requirements, such as STARS ,QARR, MMCOR, MEDS, RAPS and HEDIS is a strong plus. + Experience… more
- CVS Health (Concord, NH)
- …sales, marketing, provider relations, network development, utilization management, and/or STARS /HEDIS quality improvement , and Revenue Integrity efforts. ... CVS Health's unrivaled presence in local communities and their pharmacy benefits management capabilities, we're joining members on their...broad set of stakeholders, engage, and inspire others, and lead by example. Ability to lead teams… more
- CenterWell (Tallahassee, FL)
- …population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as they relate to ... the MSO across the engagement lifecycle, from first communication with the practice. + Lead the affiliate market team with an eye to develop and maintain a strong… more
- CVS Health (Tallahassee, FL)
- …(Dual-Eligible Special Needs Plan / Medicare-Medicaid Plan) * Develop and lead clinical strategy and objectives for the DSNP/FIDE populations, including the ... are evidence-based. * Work collaboratively with the Behavioral Health, Pharmacy , Member Outreach, Care Management, National Quality Management, Utilization… more
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