- Robert Half Office Team (Minneapolis, MN)
- …employment opportunity in the Healthcare industry. This role is for a Retrieval Specialist who will be instrumental in enhancing the quality of our services through ... medical record requests * Perform medical record reviews for risk adjustment, HEDIS and HEDIS -like measures via remote EMR access or onsite * Schedule on-site… more
- Robert Half Accountemps (Minneapolis, MN)
- Description Do you have HEDIS experience? Join a Fortune 500 Healthcare company on a fully remote, long term contract opportunity with potential for full time hire! ... during the month of November due to training. Position: Retrieval Specialist + Retrieval Operations integrates talented individuals with expertise and experience… more
- System One (Baltimore, MD)
- ALTA IT Services is staffing a contract opportunity for a Clinical HEDIS Specialist support a leading health insurance customer. The main duties include ... conducting thorough HEDIS overreads in line with NCQA guidelines. Additional tasks...Additional tasks involve helping with Medical Record Retrieval for HEDIS and Risk Adjustment, participating in internal audits for… more
- Centers Plan for Healthy Living (Garden City, NY)
- …collect, and secure clinical documentation from Primary Care Physician (PCP) and/or Specialist (s) as indicated by HEDIS measures. + Review assigned medical ... HEDIS Reviewer 990 Stewart Ave, Garden City, NY...plans they need for healthy living. JOB SUMMARY: The HEDIS Reviewer is responsible for supporting the overall direction,… more
- Molina Healthcare (Columbus, OH)
- …accreditation surveys and federal/state QI compliance activities. **Quality Improvement, HEDIS , Healthcare experience is very important for this position. Candidates ... Please identify this experience on your resume.** **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Interventions / QI Compliance contributes to one or… more
- Edward M. Kennedy Community Health Center, Inc. (Worcester, MA)
- …sites to support this growth. We are currently hiring a Document Imaging Specialist based in Worcester. The Document Imaging Specialist ensures health record ... records and retired record logs. + Coordinate and manage requests for HEDIS reviews, including scheduling reviewers, maintaining records of patients reviewed and… more
- Health First (Rockledge, FL)
- *POSITION SUMMARY* The Provider Network Credentialing Specialist is responsible for coordinating, monitoring and maintaining the credentialing and re-credentialing ... and meets all regulatory and accreditation requirements and works with on-site NCQA, HEDIS and CMS auditors as needed. 2. Provide reports to internal departments for… more
- Molina Healthcare (Edinburg, TX)
- …federal/state QI compliance activities. **Candidates with experience in a Quality/ HEDIS /Clinical setting will receive first consideration. Please identify that ... experience on your resume.** **KNOWLEDGE/SKILLS/ABILITIES** The Specialist , Quality Interventions/ QI Compliance contributes to one or more of these quality… more
- The Cigna Group (Nashville, TN)
- **Coding Education Specialist (AHIMA or AAPC certified) -** **Philadelphia, PA or Nashville TN** We value our talented employees, and whenever possible strive to ... Professional Coder (CPC) Certified Risk Adjustment Coder (CRC) Certified Coding Specialist for Providers (CCS-P) Certified Coding Specialist for Hospitals… more
- Centene Corporation (Baton Rouge, LA)
- …all clinical initiatives including, case and disease management, behavioral health and HEDIS outcome measures + Evaluate the analysis and responses on all quality ... (LAC) or Advanced Practice Registered Nurses (must be a nurse practitioner specialist in Adult Psychiatric & mental Health, Family Psychiatric & Mental health,… more
- Molina Healthcare (NM)
- …monitoring for key performance measurement activities. **Knowledge/Skills/Abilities** The Senior Specialist , Provider Engagement contributes to one or more of these ... quality improvement functions: * Acts as a lead specialist to provide project-, program-, and / or initiative-related...(RN may be preferred for specific roles) * Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
- AdventHealth (Westwood, KS)
- **Quality Measure Specialist -AdventHealth** **All the benefits and perks you need for you and your family:** . Benefits from Day One . Paid Days Off from Day One . ... KS 66205** **The role you'll contribute:** The Quality Measure Specialist performs a wide variety of tasks to be...quality measures (including but not limited to ACO, CMS, HEDIS etc) . Support and maintain outreach initiatives and… more
- Robert Half Office Team (St. Paul, MN)
- Description The Retrieval Specialist will play a vital role in the data collection cycle within Retrieval Operations, which focuses on risk adjustment and quality ... critical incidents immediately. + Review medical records for risk adjustment and HEDIS (R)-related measures via remote EMR access or onsite visits. Robert Half is… more
- Elevance Health (Olathe, KS)
- …miles of our Olathe or Topeka PulsePoint. The **Clinical Quality Program Specialist ** is responsible for supporting projects and assisting the quality improvement ... an equivalent background. **Preferred skills, qualifications and experience:** + Experience with HEDIS strongly preferred + BS in health administration, nursing or a… more
- VNS Health (Manhattan, NY)
- …or specialist to address non-adherence and/or clinical diagnosis for HEDIS /QARR exclusion. + Participates and leads improvement teams and projects and other ... committees related to performance improvement, measurement and documentation. + Performs audits on medical records and provide counseling/guidance to PCPs on VNS Health Medical Record Documentation Standards. + Conducts audits of patient care records. Develops… more
- InnovaCare (Ponce, PR)
- …passion and customer focus to the business. POSITION DESCRIPTION The Quality Specialist Nurse is responsible for monitoring quality of care and services delivered ... policies and procedures. Performs medical record review in physician's offices of selected HEDIS sample. Performs follow audit to those providers with a score below… more
- Sharp HealthCare (San Diego, CA)
- …related to quality improvement and outreach initiatives, including screenings, HEDIS , health fairs, disease management and other projects, as necessary.Coordinates ... the development and distribution of provider education information such as the Provider Operations Manual, provider alerts, and provider newsletters. + RegulatoryCoordinates, facilitates and records Joint Operating Committee meetings at plan medical group… more
- Centene Corporation (Omaha, NE)
- …HBR (Health Benefits Ratio) analyses, Health Information data Information Set ( HEDIS ) analyses, and create reports for provider Review provider performance by ... both quantitative metrics and qualitative factors + Create and communicate milestone documents, dashboards and success or improvement metrics + Act as a liaison between the provider and the health plan ensuring a coordinated effort in improving financial and… more
- Highmark Health (Harrisburg, PA)
- …utilization management, immunizations, specialty pharmacy, Medicare Stars, and Medicaid HEDIS to strategies designed to promote the Organization's value based ... substitution, medication adherence, success in pharmacy related Stars and HEDIS measures, completion of comprehensive medication reviews, adherence to pharmacy… more
- ChenMed (Columbus, OH)
- …any necessary copays for services. Assists with scheduling follow-up and in-house Specialist referral appointments, when necessary. + Escorts patients to exam rooms ... comfort and well-bring prior to leaving. + Acts as HEDIS champion for the PCP by providing visibility of... champion for the PCP by providing visibility of HEDIS needs for scheduled patients. Reports on hospitalizations including… more
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