- Molina Healthcare (Ypsilanti, MI)
- …review which includes ongoing review of records submitted by providers and the annual HEDIS medical record review. The Senior Specialist will be asked to perform ... Improvement RN will work in remote setting supporting Maternity Medicaid population. Connect with Medicaid members to...Collects medical records and reports from provider offices, loads data into the HEDIS application, and compares… more
- Molina Healthcare (Seattle, WA)
- …Health or Healthcare. **Preferred Experience** + Understanding and experience with Quality and HEDIS measures. + Proficient with data and reports + Knowledge of ... risk adjustment + 1 year of experience in Medicare and in Medicaid . + Experience with data reporting, analysis and/or interpretation. + 1 year of experience in… more
- Humana (Oklahoma City, OK)
- …services and close gaps in care for Oklahoma Medicaid enrollees. The Senior Quality Compliance Professional has proven data analysis skills and a strong ... part of our caring community and help us put health first** The Senior Quality Compliance Professional uses quality compliance and improvement tools and methodology… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Senior Quality Improvement Professional is an integral part of the Florida Quality Improvement ... customers to complete fast-paced and time sensitive projects. The Senior Quality Improvement Professional will ensure The Florida Agency...role is expected to research, gather information and analyze data in an expedited timeframe and use QI tools… more
- Insight Global (Charlotte, NC)
- …following established care standards Monitor patient care quality using available data and chart reviews Assist in coordinating patient services, including specialty ... discussions with the Regional Medical Director (RMD) regarding care quality, outcome data , policies, procedures, and records Explore growth opportunities for new or… more
- Molina Healthcare (AZ)
- …health plan 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
- CVS Health (Springfield, IL)
- …personal, convenient and affordable. **Position Summary** Aetna Better Health is Aetna's Medicaid managed care plan. Backed by over 30 years of experience managing ... with a broad array of health care needs, our Medicaid plans have demonstrated that getting the right help...of the Quality team to ensure maximal performance with HEDIS and accreditations. + Serving as the SPOC on… more
- Molina Healthcare (FL)
- **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
- Conviva (Tampa, FL)
- …Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating multiple centers across ... and quality for patients and monitors care using available data and chart reviews. + Assists in the coordination...in the local primary care "on-call" program of Conviva Senior Primary Care. + Assures personal compliance with licensing,… more
- CenterWell (Durham, NC)
- **Become a part of our caring community and help us put health first** CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary ... Missouri, Nevada, North Carolina, South Carolina and Texas. CenterWell Senior Primary Care has a strong emphasis on ...and quality for patients and monitors care using available data and chart reviews. + Assists in the coordination… more