Average salary: $105,259 /yearly
More statsSearch Results: 12 vacancies
...Preferred Experience
• Peer Review, medical policy/procedure development, provider contracting experience.
• Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems,...
HEDIS
Work experience placement
...for identifying gaps in or barriers to care; assisting Members with scheduling transportation to appointments; reviewing EPSDT and HEDIS data to inform targeted interventions to increase utilization of well-child visits, screenings, exams, and associated services; and...
HEDIS
Hourly pay
Work experience placement
...PREFERRED EXPERIENCE:
Peer Review, medical policy/procedure development, provider contracting experience.
Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems,...
HEDIS
Work experience placement
Local area
...reportable adverse conditions, the analysis of credentialing files, the analysis of quality metric data, including, but not limited to, HEDIS, STARS, etc., the analysis of medical records data, etc.
JOB QUALIFICATIONS
Required Education
Bachelor's Degree or...
HEDIS
Remote job
Work experience placement
Immediate start
...Alternative Payment programs including but not limited to the following: CHQCA and community provider practices including training on HEDIS measures and annual quality abstraction to support (Medicare Shared Savings Program).
This position is responsible for the...
HEDIS
Full time
Relocation
...a focus on regulatory compliance and/or auditing required. Program management experience in the areas of NCQA accreditation and/or HEDIS/CMS Star performance measurement systems required. Experience developing, implementing and evaluating clinical interventions preferred...
HEDIS
Full time
Temporary work
Local area
Immediate start
Weekday work
Monday to Friday
...Health Quality (CPHQ)
Active, unrestricted Nursing License (RN may be preferred for specific roles)
Active, unrestricted Certified HEDIS Compliance Auditor (CHCA)
To all current Molina employees: If you are interested in applying for this position, please apply...
HEDIS
Remote job
Work experience placement
...license in the state of Illinois
~ Must have license/certification: APRN, Certified Nurse Practitioner
~ Knowledge of the HCC model, HEDIS, and STAR quality measures
~ Effectively communicate with elderly and chronically ill members
~ Proficient in the use of...
HEDIS
Contract work
Part time
For contractors
Immediate start
Flexible hours
...complex group leadership to engage in improving Stars measures to be 4 STARS or higher
Provide analytical interpretation of Stars and HEDIS reporting, including executive summaries to plan and provider groups
Be the primary subject matter expert for all STARS related...
HEDIS
Full time
Local area
Night shift
...visit volume.
Participates in developing and implementing organization specific initiatives around coding, documentation, STAR, HEDIS, and PCMH.
Participates in weekly and monthly meetings with operations leadership and regional director to decide on strategy for...
HEDIS
Full time
Local area
Relocation
Shift work
Monday to Friday
...working knowledge of health plan operations (compliance, finance, encounters, claims adjudications, networks, clinical, case management, HEDIS measures, etc.)
Collaborate with internal partners to complete projects and to address on-going pharmacy service needs of the plan...
HEDIS
Remote job
Full time
Local area
...contractual requirements, and pay for performance initiatives
Serves as subject matter expert (SME) for Women’s Health Medicaid/Medicare HEDIS / CMS measures, preventive health topics; leads efforts with clinical team to research and design educational materials for use in...
HEDIS
Remote job
Full time
Work from home
Home office
Shift work
Monday to Friday
