- Molina Healthcare (NM)
- **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality improvement ... **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 4-6 years of Medicare Stars Program and project management experience Demonstrated knowledge… more
- Humana (Lakeland, FL)
- …(RN) is responsible for the development, implementation and management oversight of the company's Medicare Stars Program in the Florida region. *Central and ... Florida area and Panhandle. Far north Florida limit would be Jacksonville The Senior Stars Improvement Clinical Professional (RN) + Develops programs designed to… more
- CenterWell (San Antonio, TX)
- …2 responsible for the development, implementation and management oversight of the company's Medicare /Medicaid Stars Program . The Stars Improvement, ... and independent determination of the appropriate courses of action. The Stars Improvement Clinical Professional (RN) collaborates with market leadership, and quality… more
- CenterWell (Covington, LA)
- …2 responsible for the development, implementation and management oversight of the company's Medicare /Medicaid Stars Program . The Stars Improvement, ... and independent determination of the appropriate courses of action. The Stars Improvement Clinical Professional (RN) collaborates with market leadership, and quality… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Acts as a subject ... matter expert and collaborates with various internal departments to ensure that Medicare Advantage (MA) clinical programs and regulatory reporting are compliant with… more
- CVS Health (Raleigh, NC)
- …EST standard business hours. No nights, no weekends and no holidays. The Senior Clinical Strategist works with assigned Aetna Medicare Provider Collaboration ... Projects will support population health and will primarily impact Stars and quality but will also focus on improvements...also focus on improvements in utilization and cost. The Senior Clinical Strategist works to drive clinical performance of… more
- CVS Health (New York, NY)
- …budget of the Medicare plans within the Market. + Direction of senior leaders of specific functional areas as assigned. Functional areas may include operations, ... every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products in their market, supporting… more
- CenterWell (Montgomery, AL)
- …Kentucky, Tennessee, Louisiana, and more. The PCO has a strong emphasis on senior -focused primary care for members of Medicare Advantage health plans and ... and outcomes **Required Qualifications** + Expertise in value-based care, especially Medicare Advantage, with familiarity of HEDIS/ STARS , medical risk… more
- Highmark Health (Albany, NY)
- …savings outcomes as a result of workflow transformation, superior coding accuracy, and Medicare STARS gap closure to providers based upon each individual ... for superior coding accuracy, cost and utilization reports, medical loss ratio reports, Medicare STARS gaps and other risk revenue opportunities. + Function as… more
- Humana (Oklahoma City, OK)
- …quality improvement programs for all lines of business including annual program description, work plan, and annual evaluation. The Quality Improvement Professional ... courses of action. This position will partner closely with the Sr . Quality Improvement Professional(s) on projects and deliverables. The Quality Improvement… more