- Centene Corporation (Austin, TX)
- …experience with data analysis, interpreting statistical data , assessing HEDIS performance, resolving data quality issues, and tracking compliance ... 8:00 am - 5:00 pm (CST)** **Position Purpose:** Perform duties to ensure HEDIS data accuracy and reporting, including investigation, auditing, and improvement… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …outreach, customer service or care coordination is required. + Knowledge of HEDIS measures, Medicare/Medicaid quality programs and mediation adherence is ... of this position is to support the health plan's quality and performance goals, with a focus on achieving...This includes conducting outbound calls to members to close HEDIS gaps in care, discussing the importance of medication… more
- Florida Health Care Plans, Inc. (Daytona Beach, FL)
- …Flagler, Seminole, Brevard, and St. Johns Counties POSITION SUMMARY: The role of the Quality Improvement Coordinator is to improve the quality and safety ... claims system, clinical informatics reports, national guidelines, NCQA standards, HEDIS specifications, CMS regulations and other applicable resources. QUALIFICATIONS:… more
- LA Care Health Plan (Los Angeles, CA)
- Quality and Population Health Coordinator I (ALD) Job Category: Administrative, HR, Business Professionals Department: Health Education Location: Los Angeles, ... net required to achieve that purpose. Job Summary The Quality and Population Health Coordinator I (QPHC)...patients and health care providers. Preferred: Some knowledge of HEDIS and other quality measures. Some knowledge… more
- Centene Corporation (Tacoma, WA)
- …quality program description, work plan goals including applicable Healthcare Effectiveness Data and Information Set ( HEDIS ) measures and program evaluation ... activities to ensure compliance with customer expectations and lead clinical quality initiatives. Review clinical information for appeals to determine medical… more
- Centene Corporation (Jacksonville, FL)
- …care gap closure documentation, medical record data abstraction and over-reads of HEDIS and other quality related measures. This is a hybrid role and ... including a fresh perspective on workplace flexibility. **Position Purpose:** Perform quality improvement activities including, but not limited to, member and or… more
- AmeriHealth Caritas (Greenville, NC)
- …and problem solving skills to ensure successful delegation arrangements and quality data reporting. **Education/Experience:** + Bachelor's Degree Or equivalent ... Population Health and Care Management team, the Care Management Oversight Coordinator will interface with delegated provider groups and clinically integrated… more
- Trinity Health (Clive, IA)
- …or more years of experience in medication therapy management, Medicare STARS or HEDIS quality measures, managed care pharmacy, or population health + Familiarity ... sources to define pharmacy management opportunities. + Understanding and experience with quality data , risk adjustment, value-based payment models Proven ability… more
- Adelante (Phoenix, AZ)
- …Qualifications ESSENTIAL SKILLS AND EXPERIENCE: + Knowledge of WIC program guidelines, data analysis and reporting, quality assurance and compliance monitoring, ... vulnerable populations. + Bachelor's degree, preferred. Prior experience in quality assurance, data collection, and communications can...degree + Experience in managed care with knowledge of HEDIS and STARS Quality Metrics preferred +… more
- LA Care Health Plan (Los Angeles, CA)
- …Care pharmacists to collaborate with QI STARs team on process improvement for various HEDIS quality metrics Qualifications: * Must be currently enrolled in an ... Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and...management reviews and approves it. Conducts research and gathers data for reports and presentations. Compiles and consolidate reports… more
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