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Manager Management

Yulan, NY map
... o Assist client’s to drill down to the risk drivers, HEDIS, CAHPS, NCQA measures, and gaps in care in the hard to find hidden costly members. Driving quality healthcare by finding actionable members to engage with. o Predictive analytics are used to ... - Oct 11

Project Manager

India, Bengaluru, Karnataka map
... generated from different sources of DB like ezcap, HEDIS, CMS, Medicaid and Medicare claims, generating the various reports/metrics to understand the trends,PMPM like ACO summary dashboard, Quality Measure, John Hopkins, Network Utilizations etc. ... - Oct 07

Manager Project

New York, NY map
... Alpha Care, Brooklyn, NY (09/2014 – 03/2015) Hands-on lead of Quarter Annual files processing (Member Demographic, Enrollment, Claims, Rx Claim and Provider) between Alpha Care and Verisk Health in order to support HEDIS Quality Measures Reporting. ... - Oct 05

medical billing

Lithia Springs, GA map
... Collect member records and conduct reviews of these records by contacting providers and placing the results collected into a specific data base for HEDIS/PIA review. Review all patient files for accuracy, and coding that information into the ... - Oct 03

VP Application Development Division

Dallas, TX map
... Health Employee Data Information Systems(HEDIS): This project involved a lot of quantitative and qualitative analysis/programming of Kaiser's inpatient, outpatient, referrals, pharmacy and claims systems. The programming for this project was done ... - Sep 29

Customer Service Medical

United States map
... emergency department, medical/ surgical, ICU, CCU, open herat unit, recovery room, GI unit, Detox, clinics, Health care Quality improvement Specialist including Hedis inspection, and Emergency Department at the Veteran's Hospital in Buffalo, NY. ... - Sep 24

Medical Billing Manager

Bonita Springs, FL map
... understanding of HEDIS and HCC coding; management breadth to direct and motivate; highly developed communication skills; political savvy; and the ability to develop clear action plans and drive process, given often ambiguous issues with numerous ... - Sep 16

Manager Management

San Francisco, CA map
... PROFESSIONAL EXPERIENCE 3/2010-PRESENT BLUE CROSS BLUE SHIELD DURHAM, NC OF NORTH CAROLINA Director, Quality Management Responsibilities include accountability for organization-wide NCQA accreditation, Medicare Stars and HEDIS outcomes, provider ... - Sep 12

Manager Medical

Los Angeles, CA map
... faculty monitored students referred for illness Documentation Health Net, Los Angeles, CA 01/15 – 05/15 Clinical Abstractor (HEDIS) (Contract) Responsible for abstracting clinical data elements from electronic health records (EHRs) and paper medical ... - Sep 09

Project Manager Management

CA map
... Extensive experience in coding for performance programs within CMS Medicare Advantage retrospective chart review in the area of HCC/P4P/RADV/ STARS/HEDIS. Manage, analyze, strategize, create, improve and implement new operational processes across ... - Sep 09
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