• HEDIS Reviewer

    Centers Plan for Healthy Living (Garden City, NY)
    HEDIS Reviewer 990 Stewart Ave, Garden City, NY 11530, USA Req #879 Tuesday, November 5, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... plans they need for healthy living. JOB SUMMARY: The HEDIS Reviewer is responsible for supporting the...supporting the overall direction, coordination and implementation of the HEDIS Medical Record Review process for Centers… more
    Centers Plan for Healthy Living (11/06/24)
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  • HEDIS Reviewer II

    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 ... 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
    US Tech Solutions (10/18/24)
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  • HEDIS Reviewer II

    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
    US Tech Solutions (11/06/24)
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  • Sr. Abstractor, HEDIS /Quality Improvement…

    Molina Healthcare (TX)
    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 (11/22/24)
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  • HEDIS Quality Associate - Hedis

    Health First (Rockledge, FL)
    …record evaluation and follow-up education as required. ** *Stewardship: * * Accurately review , abstract, data enter and overread HEDIS data from qualified ... Customer Service and Stewardship by contributing to Health First Health Plans HEDIS activities that support regulatory compliance, CMS STARS, NCQA Accreditation and… more
    Health First (09/04/24)
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  • Sr Mgr, HEDIS Measures Team

    CVS Health (Kansas City, MO)
    …and affordable. **Position Summary** The Healthcare Effectiveness Data and Information Set ( HEDIS ) is one of the most widely used healthcare quality data sets ... in the country. HEDIS calculates how health care organizations perform on various...regular, timely feedback as well as the formal performance review process to ensure high-quality deliverables and ongoing colleague/team… more
    CVS Health (11/13/24)
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  • Coding Quality Auditor, HEDIS *Remote

    Providence (OR)
    …using objective specifications for the Healthcare Effectiveness and Data Information Set ( HEDIS ) program + Conduct Audits inclusive of review of outpatient ... empower them._** **Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:** + Be responsible for conducting clinical quality audits/overreads… more
    Providence (11/16/24)
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  • HEDIS Quality LPN

    Robert Half Accountemps (Houston, TX)
    …a short-term contract employment opportunity. Responsibilities: * Assist in medical records review to identify Star/ HEDIS opportunities for the medical staff. * ... Description We are seeking a HEDIS Quality LPN to join a fully remote team. The HEDIS Quality LPN focuses on HEDIS operations and data collection. The … more
    Robert Half Accountemps (11/21/24)
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  • HEDIS Overreader Registered Nurse

    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 (10/01/24)
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  • Clinical Nurse Auditor, HEDIS *Remote

    Providence (WA)
    …using objective specifications for the Healthcare Effectiveness and Data Information Set ( HEDIS ) program + Conduct Audits, which include review of outpatient ... must empower them._** **Providence Health Plan is calling a Clinical Nurse Auditor, HEDIS who will:** + Be responsible for conducting clinical quality audits for the… more
    Providence (10/30/24)
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  • HEDIS Retrieval Specialist

    Robert Half Accountemps (Minneapolis, MN)
    …- In this role you will assist in the collection, validation, and reporting of HEDIS measures during the seasonal review period. This role is essential for ... Description Robert Half is currently hiring seasonal HEDIS support with a large Fortune Healthcare 500...contract role starting in January 2025. **Must have previous HEDIS or relevant experience to be considered!** Interested? Apply… more
    Robert Half Accountemps (11/10/24)
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  • Sr Analyst, HEDIS /Quality Reporting…

    Molina Healthcare (MI)
    …Improvement functions (eg, reporting for key performance measurement activities, including HEDIS , state-based measure reporting and medical record review ). + ... QI compliance activities. **Candidates residing in Michigan with SQL, Quality/ HEDIS and Health plan experience are strongly preferred.** **KNOWLEDGE/SKILLS/ABILITIES**… more
    Molina Healthcare (10/20/24)
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  • HEDIS Coordinator

    Actalent (Pembroke Pines, FL)
    …Microsoft Office Suite proficiency EMR experience Medical terminology OR Medical Record Review OR Medical Coding experience HEDIS knowledge Preferred: HEDIS ... Actalent is Hiring a team of HEDIS Coordinators Responsibilities: + Position Purpose: Perform duties...preferred. Skills: Quality improvement, data, audit, data abstraction, chart review , medical, quality audit, managed care, Medicare Skills &… more
    Actalent (11/20/24)
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  • Remote - HEDIS Nurse

    Actalent (Columbia, SC)
    …results to HEDIS standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS and other measure sets in ... Immediate hiring for "Remote HEDIS Nurses" in US ! Job Description: +...data collection and abstraction for company quality measures, including HEDIS , CMS, CHIPRA and/or any other custom measurements. +… more
    Actalent (11/24/24)
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  • HEDIS Nurse (Remote)

    Actalent (Austin, TX)
    …results to HEDIS standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS and other measure sets in ... Actalent is currently hiring for Remote HEDIS Nurses (RN/LPN)! Job Description: + Lead data...data collection and abstraction for company quality measures, including HEDIS , CMS, CHIPRA and/or any other custom measurements. +… more
    Actalent (11/22/24)
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  • HEDIS Nurse- REMOTE

    Actalent (Austin, TX)
    …CMS, and CHIPRA * Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom * Review medical records and abstract data ... and vendors Additional Skills & Qualifications * Recent experience with HEDIS , NCQA, Quality Initiatives/Standards. * Previous HEDIS abstraction/overread… more
    Actalent (11/09/24)
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  • HEDIS Registered Nurse or LPNs (Field…

    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
    Insight Global (10/01/24)
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  • Remote Hedis LPN

    Actalent (Philadelphia, PA)
    …results to HEDIS standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS and other measure sets in ... Remote HEDIS LPN Abstractor Description: Position Purpose: Lead data...necessary Skills: Quality improvement, data, audit, data abstraction, chart review , medical, quality audit, managed care, Medicare Work Environment… more
    Actalent (11/23/24)
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  • HEDIS LPN

    Actalent (Pembroke Pines, FL)
    …necessity appeals and denials including disposition of denials notification letters, review of clinical information to determine if medical necessity criteria are ... with Microsoft Office applications. Experience with utilization or appeals review preferred. Knowledge of InterQual criteria preferred. + License/Certification: RN… more
    Actalent (11/20/24)
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  • Remote HEDIS Coordinator

    Actalent (Orlando, FL)
    Actalent is Hiring a team of HEDIS Coordinators Responsibilities: + Position Purpose: Perform duties to ensure HEDIS data accuracy and reporting, including ... knowledge of the National Committee on Quality Assurance (NCQA). + HEDIS requirements preferred. Skills: Quality improvement, data, audit, data abstraction, chart… more
    Actalent (11/20/24)
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