- Actalent (Des Moines, IA)
- Job Title: HEDIS Nurse ConsultantJob Description We are seeking a dedicated HEDIS Nurse Consultant to support our annual Healthcare Effectiveness Data and ... Information Set ( HEDIS ) reporting. This role involves abstracting medical record data,...data, conducting medical record reviews, and ensuring compliance with HEDIS audit standards. The successful candidate will work remotely… more
- Actalent (Des Moines, IA)
- Remote HEDIS Nurse Consultant Description HEDIS work typically includes requesting records, abstracting/overreading medical records, performing claims research, ... preparing medical records for the NCQA HEDIS Auditor, etc. Abstracts medical record data from practitioner's files to support annual Healthcare Effectiveness Data… more
- Molina Healthcare (Santa Fe, NM)
- …Sr. Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The ... Duties** + Performs the coordination and preparation of the HEDIS medical record review which includes ongoing review of...review of records submitted by providers and the annual HEDIS medical record review. + Participates in meetings with… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Sr. HEDIS Coordinator position in the Quality Improvement department. This is a full time position working Monday ... Pittsburgh or surrounding area to be considered! The Sr. HEDIS Coordinator will assists with the management of ...HEDIS Coordinator will assists with the management of HEDIS Coordinator activities in addition to performing the day-to-day… more
- Providence (CA)
- …empower them._** **Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:** + Be responsible for conducting clinical quality audits/overreads ... to determine potential areas for quality improvement within the HEDIS project + Collect data by way of chart...specifications for the Healthcare Effectiveness and Data Information Set ( HEDIS ) program + Conduct Audits inclusive of review of… more
- CVS Health (Charleston, WV)
- …heart, each and every day. **Position Summary** Subject Matter Expert in HEDIS improvement work; may interact with providers, stakeholders and members to facilitate ... + Partner cross functionally to deliver tools supporting the HEDIS team. + Communicate with stakeholders on key ...HEDIS team. + Communicate with stakeholders on key HEDIS activities. + Conducts outreach with complex provider partners… more
- Humana (Frankfort, KY)
- …health outcomes, patient experience, and plan operations. The AVP, Stars HEDIS Improvement and Operations is responsible for overseeing the implementation, ... management, and continuous improvement of the Healthcare Effectiveness Data and Information Set ( HEDIS ) initiatives as part of the CMS Stars Program. This role will… more
- US Tech Solutions (Canton, MA)
- …a large-scale project involving the retrieval of electronic medical records during the HEDIS reporting period. Under the guidance of the Quality Nurse Reviewer, you ... and supporting project goals. **Key Responsibilities:** + Gain expertise in HEDIS terminology, workflows, and hybrid clinical measures through internal training. +… more
- US Tech Solutions (May, OK)
- …outreach, collection, and review of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to the start of the ... in any way possible to complete the screenings. * Search for relevant HEDIS records from databases, review medical records using HEDIS technical specification… more
- US Tech Solutions (Canton, MA)
- …months (with possibility for extension)** **Overview:** We are seeking a ** HEDIS Data Entry Administrator** to support a large-scale project involving the ... from medical records using MS Excel. + Input medical record status into the HEDIS database. + Contact non-responsive providers and document call statuses. + Fax … more
- UCLA Health (Los Angeles, CA)
- …to lead critical healthcare quality initiatives, including CMS Star Ratings and HEDIS (Healthcare Effectiveness Data and Information Set) operations. This role is ... + Lead end-to-end execution of CMS Star Ratings and HEDIS initiatives and manage the entire project lifestyle +...and manage project plans, timelines, and deliverables + Oversee HEDIS operations, including data submission, audits, and hybrid chart… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary:** The HEDIS Network Analyst will support CCA's ability to meet and surpass critical Quality ... **Essential Duties & Responsibilities:** + **Conduct weekly tracking of Quality/ HEDIS metrics, specifically focused on Initiation and Engagement of Alcohol or… more
- US Tech Solutions (Newark, NJ)
- …6+ months contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state ... audits, HEDIS measures, and quality-related complaints and referrals. + This...managed care principles and medical terminology. + Familiarity with HEDIS guidelines and URAC accreditation standards preferred. + Proficient… more
- NTT DATA North America (IL)
- HEDIS Reviewer - State of IL Position Summary: Participates in the collection and review of medical records to abstract clinical information for HEDIS quality ... Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance measures. Ensures accurate and complete documentation of required… more
- Elevance Health (Seven Fields, PA)
- **Business Information Analyst II - HEDIS Quality Analytics** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering ... multiple data sources and formats and utilizing multiple data systems to analyze HEDIS results is preferred. + Experience with relational databases and knowledge of… more
- Molina Healthcare (OH)
- …within the department and/or collaboratively with other departments. Please include any HEDIS /Quality experience on your resume. This experience is important for the ... (CPHQ) + Nursing License (RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested… more
- Molina Healthcare (Columbus, OH)
- …Quality Analytics team. Designs and develops reporting solutions to assist HEDIS audit, rate tracking, and Identifying targeted Interventions and tracking outcome. ... tracking of progress and impact of such interventions. + Assist retrospective HEDIS rate tracking and supplemental data impact reporting. + Develop Medical Record… more
- US Tech Solutions (Canton, MA)
- …record(s) and/or provider(s), and document follow-up actions during the HEDIS (Healthcare Effectiveness Data Information Set) reporting period. **Principal Duties ... and Responsibilities** + Willingness to learn basic principles of the HEDIS medical record clinical measurement via internal trainings + Follow internal workflows to… more
- Ventura County (Ventura, CA)
- …members to resolve service issues, ensure regulatory compliance (DMHC, NCQA, HEDIS ), and support wellness, prevention, and disease management programs. This position ... preventing diseases, and maintaining well-being; + Assumes responsibilities related to HEDIS , including data collection, reporting, and ensuring compliance with … more
- Highmark Health (Buffalo, NY)
- …is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office based support to ... PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value creation, cost control… more
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