Average salary: $78,312 /yearly
More stats ...Case Management documentation systems.
Ability to meet accreditation and quality standards including but not limited to NCQA and HEDIS
WOULD LOVE FOR YOU HAVE
~ Bilingual in English and Spanish preferred
COMPENSATION
Guidehealth’s compensation structure...
HEDIS
Weekly pay
Holiday work
Temporary work
Local area
Remote job
Flexible hours
...support in the home as well as delivering and coordinating across the entire care continuum.
GENERAL SUMMARY
The Quality / HEDIS Coordinator plays a critical role in supporting the organization in achieving high quality outcomes nationally. This representative...
HEDIS
Local area
...degree in related field or equivalent experience. 6+ years of business process or data analysis preferably in healthcare or 5+ years of HEDIS analysis. Advanced knowledge of Microsoft Applications, including Excel and Access preferred. Project management experience...
HEDIS
Holiday work
Remote job
Flexible hours
...expertise to ensure the timely completion of both clinical and episodic care coordination and ensures the successful attainment of HEDIS and other quality-related needs.
Essential Clinical Care Manager (RN) Functions:
* Assists physician in all aspects of the consultation...
HEDIS
Holiday work
Full time
Flexible hours
Shift work
...contracted providers
* May support contracted providers with above activities and other selected duties in appropriate markets Quality/HEDIS
* Quality/HEDIS
* The RN will review the chart and enter HEDIS/Quality information into the EMR
* The RN may identify gaps in the...
HEDIS
Holiday work
Temporary work
...and participate in regularly scheduled team meetings
Support APC in ongoing panel management and quality of care efforts (e.g., HEDIS)
Completes next day visit chart prep
Utilize reporting to help providers track, meet and exceed team goal,
Other tasks needed...
HEDIS
...connecting with patients while inpatient, scheduling transition of care visits, and completion of transition of care visits to meet HEDIS requirements. Additionally, this role will be responsible for overseeing the transitional team who serve as the primary point of contact...
HEDIS
...Employees
11-50
Specialties
Population Health Management
Value-based Care
Healthcare Analytics
Quality Measures
HEDIS Measures
Medicare Advantage
MSSP
and NCQA DAV
About the Role
The Regional Vice President will be responsible for fostering...
HEDIS
...responsible for performing clinical care reviews using criteria outlined by the Clinic's various quality incentive programs (e.g., HEDIS, CMS, etc.). The Clinical Quality Nurse works with the providers and nursing staff to implement actions to improve performance, close...
HEDIS
...Condition Categories (HCC) model within 30 days of hire
Demonstrates understanding and working knowledge of key elements of Quality STAR/HEDIS measures within 30 days of hire
Rotation of telephonic on call coverage after hours
Qualifications and Skills:
~ Current...
HEDIS
Holiday work
Temporary work
Remote job
Shift work
...WellCare. Educates providers and supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving...
HEDIS
Hourly pay
Holiday work
Contract work
Work experience placement
Remote job
Flexible hours
...patient experience. The ideal candidate will have demonstrated proficiency of healthcare data sets, including medical claims, HCC, HEDIS, and be detailed oriented. This role reports to the SVP of Data and Clinical Solutions and works closely with operational and clinical...
HEDIS
...Health Clinical Quality Program Manager is responsible for developing, implementing, and monitoring Quality initiatives to improve HEDIS and execute quality strategic priorities across the organization in compliance with NCQA MBHO standards.
How you will make an impact...
HEDIS
Holiday work
Temporary work
Local area
Remote job
Shift work
Day shift
Monday to Friday
...patient appointment
Delivers quality care while maintaining all company metrics pertaining to appropriate documentation/coding, HEDIS measures, engagement of patients, and managing medical expense.
Serves as a resource for patients in delivering ongoing care information...
HEDIS
Holiday work
Permanent employment
Full time
Flexible hours
Shift work
Monday to Friday
...ensuring alignment and integration across functional areas in support of contract administration with focus on quality performance HEDIS, STARS. Ensuring consistency and efficiency of processes within the operations domain. Manage complex, VBC program terms and collaborate...
HEDIS
Contract work
...regulations
# Develops and maintains an in-depth understanding of:
# common healthcare utilization and cost metrics, including HEDIS
# Available fund data and how it is standardized and used in production reporting
# the overall effects of changes to database design...
HEDIS
Holiday work
Temporary work
Work experience placement
Work from home
Flexible hours
Monday to Friday
...and participate in regularly scheduled team meetings
Support APC in ongoing panel management and quality of care efforts (e.g., HEDIS)
Completes next day visit chart prep
Utilize reporting to help providers track, meet and exceed team goal,
Other tasks needed...
HEDIS
...license in additional states as needed
* Minimum of 2 or more years of experience in medication therapy management, Medicare STARS or HEDIS quality measures, managed care pharmacy, or population health
* Familiarity with CMS STARS and medication adherence strategy
*...
HEDIS
Immediate start
Remote job
...patient appointment
Delivers quality care while maintaining all company metrics pertaining to appropriate documentation/coding, HEDIS measures, engagement of patients, and managing medical expense.
Serves as a resource for patients in delivering ongoing care information...
HEDIS
Holiday work
Permanent employment
Full time
Relocation bonus
Flexible hours
Shift work
Monday to Friday
...out monthly schedule in order to meet monthly productivity expectations
~ Possess knowledge of health risk evaluations including HEDIS, stars, and risk-adjustment
Preferred Requirements:
Prior knowledge or experience with oversight of 1099 contractors
Previous...
HEDIS
Holiday work
For contractors
Immediate start
Remote job
Night shift
Afternoon shift
...Documenting patient information and following physicians’ orders
Continually assessing and addressing enrollee needs and impact on HEDIS
Developing, updating and coordinating the patient’s plan of care to achieve patient goals
Providing treatment and support to...
HEDIS
Contract work
Shift work
Night shift
...production systems, manually maintained data, and standard healthcare data sets. (e.g., member eligibility, medical claims, pharmacy claims, HEDIS ECDS files)
Developing internal tools for automation of all development-related activities (data processing, QA, data validation,...
HEDIS
Local area
...specialty programs for autism and depression, and insightful analytics to improve the delivery of care.
Behavioral Health HEDIS Quality Program Director
*This is an Individual Contributor Role.*
Location: This position will work a Hybrid Model (remote...
HEDIS
Holiday work
Full time
Temporary work
Local area
Remote job
Shift work
Monday to Friday
...standardized performance metrics and standards used in the healthcare and behavioral health care field including but not limited to HEDIS measures and CLAS Standards
Strong computer skills including Microsoft Office, specifically Outlook, Teams, Excel, Visio, and PowerPoint...
HEDIS
Flexible hours
...member incentive programs. Works extensively with the VP of Care Operations to deliver a comprehensive suite of member tools to improve HEDIS and CAHPS rates for the overall program and to develop the yearly benefit and product changes and negotiate these with FEP for all...
HEDIS
Work experience placement
Local area
Overseas
...Medicare
Speaking engagements to provide thought leadership on behalf of Humana Group Medicare
Oversee quality improvement and HEDIS/STARS metrics to improvement with corporate and local market resources.
Provide guidance for the implementation of regional...
HEDIS
Contract work
Part time
Local area
Work from home
...patients and families.
Delivers quality care while maintaining all company metrics pertaining to appropriate documentation.coding, HEDIS measure, engagement of patients and managing medical expense.
Qualifications:
Experience in family practice, geriatrics, hospice...
HEDIS
Full time
...leadership experiences in management positions
Certified Case Manager (CCM) preferred
Knowledge/experience in Medicare/Medicaid and HEDIS criteria is highly desirable
Valid Driver's License and vehicle required
Ability to travel at least 30% for client meetings...
HEDIS
...Practice, Geriatrics, OBGYN, Hospitalist clinical specialty
Detail oriented and effective listener
Experience with Stars, including HEDIS, CAHPS and HOS
Prior experience in a business function or business consulting role
Additional Information:
Vaccine Policy...
HEDIS
Full time
Remote job
Work from home
...-of-care testing including diabetic A1c collection, blood pressure checks, colorectal screening kits, and other testing required by HEDIS/Stars measures. This role is essential to our organization’s goal of improving the overall experience of patient care, including the...
HEDIS
Holiday work
Temporary work
Remote job