Jobs: hedis stars medicare physician network

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless...

Position: HEDIS Quality Reviewer/ Clinical Quality Reviewer Duration: 03+ months contract (Possible extension) Location: Manhattan, NY 10004 Shift :: 9:00am- 5:00pm (Hybrid) Job Description: The primary function of the Clinical Quality Reviewer is to assess and audit medical charts for compliance with a focus on HEDIS,...

Enter Job Description... Maintain knowledge of medical record review and EMR systems. Maintain up-to-date knowledge of HEDIS, QARR and Star specifications Distribute requests for records and schedules appointments with provider offices to ensure timely completion of duties to meet internal and regulatory standards and requirements. Perform clinical audits...

Job DescriptionJob DescriptionEducation and/or Experience:  High School diploma. One year experience in clinical setting preferred. Familiarity with managed care, commercial and point of service, medical care preferred. HEDIS experience preferred. Computer literate with knowledge and experience with specific software such as Word, Excel,...

Duties:Under the direction of the Manager of Medical Record Review Operations, the HEDIS Data Reviewer is responsible for performing medical record abstraction and overread in support of Quality reporting (annual Healthcare Effectiveness Data and Information Set (HEDIS) and State EQRO) with duties including but not limited to the following: •Coordination...

Job DescriptionJob DescriptionLooking for a new career?What to be in charge or your time and build wealth? Some agents make 6-figures by year 3...Help seniors understand and enroll in Medicare plans. Millions of baby boomers are turning 65 and/or retiring and need help enrolling in Medicare and choosing a plan for their healthcare. This is a perfect position...

Borinquen Medical Centers is based in Miami, Florida and is seeking to hire a full-time HEDIS Specialist to join our team. This position is responsible for communicating provider participation information to stated internal and external customers through established processes to allow for appropriate patient scheduling and reimbursement for services rendered...

Providence Health Plan is seeking a Board-Certified physician for an influential clinical leadership role. In this position, you will be responsible for contributing to the vision and continuous development of strategies, programs, policies, and procedures that guide and oversee clinical quality and health equity initiatives, with a focus on the Providence...

Job Description General Summary This position is part of the UMMS Population Health Service Organization Value Based Care (VBC) Quality Analyst Team.  Responsible for working with management and peers on the end-to-end HEDIS measures and reporting for UMMS ambulatory provider groups for VBC and Total Cost of Care Programs (TCOC).  Under minimal...

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:• Medicaid State of Texas Access Reform (STAR) program for low-income children and...

The opportunity is with one of the fastest-growing Medical Economics teams in the country, based in Nashville, TN. As an Advisor, Medical Economics, you will be working with both Medicare Advantage and ACO/VBC pricing and reserving, with a focus on HEDIS Measures and STAR ratings, amongst a broad catalog of other fields. The Advisor, Medical Economics will...

**Overview** Leads and manages all aspects of data for the HEDIS/STARS/QARR/QIP functions, which includes but are not limited to, data collection and submission, quality control, and reporting and analysis to meet National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS) and New York State Department of Health (NYSDOH)...

POSITION SUMMARY/RESPONSIBILITIES Serves as a key leader in driving positive change and fostering a culture of continuous improvement within the organization’s Medicare/D-SNP Model of Care delivery. Responsible for developing, implementing, and supervising initiatives to enhance the quality of care and outcomes for Medicare/D-SNP members while ensuring...

About Fallon Health Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated,...

Borinquen Medical Centers is located in Miami, FL and is seeking to hire a full time HEDIS Nurse Specialist. The HEDIS Nurse Specialist will be a member of the Quality Department working in collaboration with the different clinical departments to close care gaps. The position will utilize information collected from the EHR, health plan portals, and direct...

Job DescriptionJob DescriptionCompany DescriptionThe University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women’s and children’s health and physical...

Overview:   About Fallon Health      Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services...

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your lifes best work.(sm) This position is responsible for the coordination of HEDIS and STARs data gathering process. This evaluates the quality and completeness of clinical...

Borinquen Medical Centers is located in Miami, FL and is seeking to hire a full time HEDIS Nurse Specialist. The HEDIS Nurse Specialist will be a member of the Quality Department working in collaboration with the different clinical departments to close care gaps. The position will utilize information collected from the EHR, health plan portals, and direct...

Primary Care Physician Mobile, AL We are seeking a compassionate and dedicated Physician to join our team and provide exceptional care to our senior patient population. As a vital member of our healthcare team, the incoming Physician will play a pivotal role in ensuring the well-being and quality of life of our elderly patients. Primary Care Physician -...