- Geisinger (Danville, PA)
- …running a HEDIS engine. + 5+ years of experience in analyzing HEDIS measure results at the data level, investigating compliance/non-compliance reasons + 5+ ... years of experience in supporting regulatory quality reporting . Work is typically performed in an office or...dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of… more
- Molina Healthcare (AZ)
- …contributes to one or more of these quality improvement functions: * Will create actionable HEDIS data and analytic insights. * Acts as a lead specialist to ... year of experience in Medicare and in Medicaid. Experience with data reporting , analysis and/or interpretation. **Preferred License, Certification, Association**… more
- Humana (Columbus, OH)
- …provide data for HEDIS and other healthcare quality measures. The Data and Reporting Lead will create, review, stratify and identify opportunities to ... scope and complexity ranging from moderate to substantial. The Data Reporting Lead will pull healthcare ...Clinical Performance, key benchmarks and improve Quality outcomes, (ie, HEDIS , NCQA, CAHPS, PIPS and state regulatory requirements) +… more
- Humana (Columbus, OH)
- …includes Provider Service Experience, Network Optimization, Clinical Services, Value-Based contracting, HEDIS and Risk Adjustment. Reporting to the Associate ... financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and… more
- Centene Corporation (St. Louis, MO)
- …resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS . + Under general guidance form Senior Quality Practice Advisors ... regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures,...identified databases and ensure accuracy in medical records for data collection, DE and reporting . + Performs… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …with respect to quality and utilization performance standards. Develops standard reporting and analytics to support Value Based Contracting (VBC) initiatives. ... cost analysis. **Provider Network Performance Analyst I** + Gathers and maintains data from multiple sources and conducts quality assurance to identify potential… more
- Universal Health Services (Reno, NV)
- …that the members' risk scores are optimized and compliant with regulatory reporting standards. The Senior Director has programmatic oversight and responsibility ... analytic and reporting tools, and assists in the development of data collection systems and workflows to fulfill CMS and quality measurement requirements.… more
- CareOregon (Portland, OR)
- …Excel for data analysis and skills with large administrative database reporting functions and/or relational databases + Strategic thinker with ability to gather ... Exemption Status Exempt Requisition # 24297 Direct Reports n/a Manager Title Director, Data Science, and Informatics Pay & Benefits Estimated hiring range $ 87,135 -… more
- Trinity Health (Clive, IA)
- …all statewide value based contracts, including contract terms, performance, payer reports, data , etc. + Oversee payer reporting requirements including manual and ... (ie reporting , analysis, operational insights) required. In-depth knowledge of HEDIS measures strongly preferred. Strong skills in MS Office suite (Excel,… more
- CVS Health (Austin, TX)
- …role, that effectively influences and achieves results without having a direct reporting relationship with dependent partners. . Must understand how quality programs ... such as NCQA and HEDIS affect the Plan. . The ideal candidate will...subject matter expertise and experience in healthcare, quality, healthcare data management, process improvement, medical management operations, including UM,… more
- Emanate Health (Covina, CA)
- …as HEDIS , STARS,ICD-10, HCC/RAF, and a proficiency in analytic reporting required. **Minimum License Requirement :** CPC, CRC and project management ... The Director Clinical Quality & Risk Management is a senior role at Emanate Health and a member of...Emanate Health and a member of the leadership team. Reporting to the Vice President of Clinical Integration and… more
- Molina Healthcare (Las Vegas, NV)
- …of experience in Medicare and in Medicaid. + Experience with data reporting , analysis and/or interpretation. **Preferred License, Certification, Association** ... of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement… more
- Fallon Health (Worcester, MA)
- …results and reporting outcomes. Other key responsibilities include medical record data abstraction for Healthcare Effectiveness Data and Information Set ( ... LinkedIn. **Brief summary of purpose:** Under the general direction of the Senior Manager, Clinical Quality, the clinical nurse analyst is responsible for developing… more
- ERP International (Camp Pendleton, CA)
- …administrative duties, which include maintaining statistical records of workload and data entry and analysis of patient outcomes. * Maintain educational materials ... the awareness of available electronic resources. * Collaborate with PHP Project Manager/ Senior Strategist to construct an annual strategic plan to target DON… more
- Molina Healthcare (Las Vegas, NV)
- …of experience in Medicare and in Medicaid. + Experience with data reporting , analysis and/or interpretation. **Preferred License, Certification, Association** ... of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement… more
- Cleveland Clinic (Cleveland, OH)
- …levers including attribution, quality, utilization, and risk documentation. + Supports data collection, analysis, reporting , and supplemental data ... documents, and executive presentations that clearly and professionally communicate to senior level audiences. + Analyzes industry trends, patient needs, and internal… more
- CVS Health (Chicago, IL)
- …Illinois. + Registered Nurse, preferably in the State of Illinois. + Experience with data analytics reporting and analysis used to help serve managed care ... of the Quality team to ensure maximal performance with HEDIS and accreditations. + Serving as the SPOC on...skills to effectively work across a wide range of senior stakeholders to drive alignment and results. + Extensive… more