• Senior Nurse STARS

    Humana (Oviedo, FL)
    …a part of our caring community and help us put health first** The Nurse Senior Stars Improvement , Clinical Professional/ Consultant contributes to the ... management of the company's Medicare/Medicaid Five-Star Quality Rating System. The Senior Stars Improvement , Clinical Professional works directly with… more
    Humana (10/03/25)
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  • Senior Project Manager of HEDIS and CMS…

    UCLA Health (Los Angeles, CA)
    Description UCLA Health is seeking an experienced Senior Project Manager to lead critical healthcare quality initiatives, including CMS Star Ratings and HEDIS ... submission, audits, and hybrid chart abstraction + Collaborate with clinical , operations, and compliance stakeholders + Facilitate cross-functional workgroups to… more
    UCLA Health (08/21/25)
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  • Director, Medicare STARS Analytics…

    Banner Health (AZ)
    …Ratings methodologies. + **Serve as a strategic advisor** on the BMA Stars team, contributing to performance improvement activities and cross-functional ... **Department Name:** Medicare Stars Strategy **Work Shift:** Day **Job Category:** General...cut points, and performance metrics, to guide analytics and improvement initiatives. + **Develop, maintain, and enhance predictive modeling… more
    Banner Health (10/16/25)
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  • Senior Clinical Strategist

    CVS Health (Albany, NY)
    …hours. No nights, no weekends and no holidays. **Position Summary** The Senior Clinical Strategist works with assigned Aetna Medicare Provider Collaboration ... also focus on improvements in utilization and cost. The Senior Clinical Strategist works to drive ...Data Team, Medical Operations and others on initiatives for Stars /quality improvement **Required Qualifications** - Registered Nurse… more
    CVS Health (10/15/25)
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  • Quality Improvement RN - Chesapeake

    CenterWell (Hampton, VA)
    …interpretation and independent determination of the appropriate courses of action. The Stars Improvement Clinical Professional (RN): + Collaborates with ... caring community and help us put health first** The Stars Improvement , Clinical Professional 2...insurance and many other opportunities. **About Us** About CenterWell Senior Primary Care: CenterWell Senior Primary Care… more
    CenterWell (10/16/25)
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  • Bilingual Quality Improvement RN - South

    CenterWell (Tampa, FL)
    **Become a part of our caring community and help us put health first** The Stars Improvement , Clinical Professional (RN) is responsible for the development, ... Stars Program in the North Florida market. The Stars Improvement , Clinical Professional (RN)...insurance and many other opportunities. **About Us** About Conviva Senior Primary Care: Conviva Senior Primary Care… more
    CenterWell (10/08/25)
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  • CAHPS Operations & Improvement Lead Product…

    Humana (Louisville, KY)
    …on Stars and other quality metrics. + Lead continuous improvement initiatives, leveraging data analytics and customer feedback to enhance survey effectiveness ... comprehensive analytics that are meaningful to develop forecasting and targeted improvement in healthcare quality with our Medicare population. This role will… more
    Humana (09/25/25)
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  • AVP, Quality Improvement (Remote…

    Molina Healthcare (IA)
    …to learn new information systems and software programs. **Preferred Experience** + CAHPS improvement experience + STARS improvement experience + State QI ... quality metrics like PQI (hospital), NQF-sanctioned measurement. + Experience with clinical intervention concepts, design of quality improvement projects (QIPs),… more
    Molina Healthcare (10/18/25)
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  • Associate Center Clinical Director

    ChenMed (Margate, FL)
    …+ Knowledge and experience in a managed care delivery system. + Knowledge of clinical outcomes and quality improvement processes. + Experience of population risk ... center. The incumbent in this role is accountable for maximizing overall clinical value while engaging physicians to improve clinical quality, efficiency,… more
    ChenMed (09/09/25)
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  • Quality RN

    CenterWell (North Charleston, SC)
    …+ Quality/ clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial performance and incentive programs + ... without restriction in applicable state + 5+ years of clinical nursing experience + Proven work experience as a...a HEDIS Nurse or similar role in healthcare quality improvement + Strong knowledge of HEDIS/ Stars /CMS +… more
    CenterWell (10/16/25)
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