- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager of HEDIS or her/his delegate, the HEDIS Abstraction & Review Specialist will support quality controls for the ... HEDIS Medical Record Review . HEDIS ratings are one tool used to assess Commonwealth Care Alliance's performance in a set of clinical effectiveness measures… more
- Molina Healthcare (AZ)
- … HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. + Assists with projects and process improvement initiatives ... **Job Duties** + Performs the coordination and preparation of the HEDIS medical record review which includes ongoing review of records submitted by… more
- Molina Healthcare (MI)
- … HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. + Assists with projects and process improvement initiatives ... **Job Duties** + Performs the coordination and preparation of the HEDIS medical record review which includes ongoing review of records submitted by… more
- Molina Healthcare (Sioux City, IA)
- … HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. **Job Qualifications** **REQUIRED EDUCATION:** High School Diploma ... well as minimum over read standards. **Job Duties** + Coordinates the HEDIS medical record review which includes ongoing review of records submitted by… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …reviewers. He/she will assist the Program Manager in the training of all temporary HEDIS review staff and will provide direct supervision of temporary staff as ... to meet our accreditation and regulatory requirements. Job Responsibilities: The HEDIS Medical Record Specialist will assist the Program Manager in preparing… more
- Insight Global (Philadelphia, PA)
- …position in PA or NJ. This is a fully remote position and requires previous HEDIS review experience. This person will be responsible for Quality Check of FDC/ ... Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills and Requirements Previous HEDIS review experience Active RN License or… more
- Insight Global (Philadelphia, PA)
- …) Strong computer skills Ability to occasionally travel to local providers Previous HEDIS review experience or experience with Utilization Review , Quality, ... Job Description A client of Insight Globals is looking for HEDIS RNs or LPNs for a partially remote contract position in PA and NJ. PARTIALLY remote position as it… more
- US Tech Solutions (May, OK)
- …to assist in any way possible to complete the screenings. * Search for relevant HEDIS records from databases, review medical records using HEDIS technical ... Participates in the member and provider outreach, collection, and review of medical records to abstract clinical information for... of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to… more
- Actalent (Pearland, TX)
- …efforts. + Run reports and work with MS Excel. Qualification : + 2+ years of HEDIS work or medical record review experience is Mandatory + Record Review ... request and validate facility and provider addresses, and collect medical records for the HEDIS project. + Perform data entry of change of addresses into the system.… more
- CVS Health (Phoenix, AZ)
- …of the time. The QM Nurse Consultant is a work at home role. Experienced HEDIS record review nurse will be responsible for obtaining, reviewing, abstracting, and ... data entering medical records utilized for HEDIS (R) supplemental data processes. Candidate must understand the...understanding of the technical specifications in the process to review , abstract, and data enter supplemental data, collaborate with… more
- Centene Corporation (Jefferson City, MO)
- …field or equivalent work experience within a managed care environment related to HEDIS record review , quality improvement, medical coding or transferable skill ... field. Candidate Experience: Required: 1+ year of experience in related HEDIS medical record review or quality improvement with experience in data and chart… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …up to date knowledge and understanding of technical specifications for all HEDIS measures. Leads collaborative review of mapping documentation for annual ... a Subject Matter Expert to management and other departments.** **Leads collaborative review of mapping documentation for annual HEDIS Specification update… more
- LA Care Health Plan (Los Angeles, CA)
- …enters data on HEDIS forms (tool) and over reads medical record review performed by vendors. All received medical record information is abstracted and entered ... HEDIS Abstractor II (Temporary) Job Category: Clinical Department:...records to supervisor for clarification when needed. Overreads record review performed by Medical Record vendor for accuracy and… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Responsible for the support, maintenance, and developmental strategies for HEDIS throughout the AmeriHealth Caritas Family of Companies. Ensures the ... Works closely with the Quality Team and Medical Record Review vendors as needed to ensure that the medical...the medical charts meet the standards as outlined by HEDIS specifications (understanding provider chase logic). Assist as needed… more
- Martin's Point Health Care (Portland, ME)
- …a "Great Place to Work" since 2015. Position Summary Job Description The HEDIS Reviewer and Auditor - Health Plan is responsible for conducting comprehensive reviews ... complete reporting for the Healthcare Effectiveness Data and Information Set ( HEDIS ). This role involves identifying and analyzing data trends, extracting clinical… more
- US Tech Solutions (PA)
- **Job Description:** + Review and abstract relevant data from medical records to ensure compliance with HEDIS measures, clinical information and treatment ... of abstracted data to ensure it meets quality standards and aligns with HEDIS specifications Work with Providers and clinical staff to obtain the necessary medical… more
- US Tech Solutions (Canton, MA)
- **Overview:** We are seeking a ** HEDIS Coordinator** to support a large-scale project involving the collection and tracking of electronic medical records. The ideal ... and route medical records based on established workflows. + Review and validate data from medical records using MS...MS Excel. + Input medical record status into the HEDIS database. + Contact non-responsive providers and document call… more
- US Tech Solutions (May, OK)
- Job Title: HEDIS Reviewer II Location: Remote Duration: 7 months Job Description: This position interprets relevant clinical criteria through review of medical ... 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
- Centene Corporation (Jefferson City, MO)
- …in training and perform duties as the Lead Project Manager. + Support HEDIS audit deliverables and compliance requirements as necessary + Manage the full project ... life cycle, including review of various sources to assess requirements, creation of...applications + Healthcare experience; managed care experience preferred + HEDIS experience preferred **License/Certification:** + PMP certification preferred Pay… more
- Elevance Health (Mason, OH)
- **Business Information Consultant Sr ( HEDIS )** **Location:** This position will work a hybrid model (remote & office). The ideal candidate will live within 50 miles ... Health PulsePoint office locations. The **Business Information Consultant Sr ( HEDIS )** is responsible for coordinating and consolidating various impact analyses… more