- Centers Plan for Healthy Living (Garden City, NY)
- HEDIS Reviewer 990 Stewart Ave, Garden City, NY 11530, USA Req #879 Monday, September 9, 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
- 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 (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
- 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
- Molina Healthcare (Florence, KY)
- …of the performance measurement data collection, reporting and monitoring process, including HEDIS , state-based measure reporting and medical record review . + ... activities. Responsibilities include responding to RFP(s) as needed, development of the HEDIS measures matrix, HEDIS work plans, and all product timelines.… more
- Blue KC (MO)
- …financial assistance** **Employee discount program** **Job Description Summary:** The HEDIS Quality Performance Analyst RN provides clinical interpretation of ... medical records for HEDIS (R) reporting. This position involves abstraction of clinical information...for final audit: Compile all requested medical records and review each for measure requirements, Coordinate gathering of additional… more
- Providence (MT)
- …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
- 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
- Providence (OR)
- …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
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …other state specific clinical measures. + Previous experience coordinating and overseeing HEDIS medical record review , supplemental data collection and other ... oversight of the Quality Improvement Program, related work plans, quality activities, HEDIS , and STARS. This leader will develop, implement and monitor all quality… 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
- Actalent (Chattanooga, TN)
- …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 ... Lead data collection and abstraction for company quality measures, including HEDIS , CMS, CHIPRA and/or any other custom measurements. Responsibilities: * Assess… more
- Centene Corporation (Olympia, WA)
- …leadership and/or customers + Manages multiple complex and variable tasks and data review processes with no supervision within targeted timelines and succeeds in a ... of the level of this position. **Preferred Skills:** + Experience with PowerBI + HEDIS experience **Technical Skills:** + One or more of the following skills are… more
- TEKsystems (Baltimore, MD)
- …member of a team - Advanced Current knowledge of clinical practices related to HEDIS and Medical Record Review - Advanced Strong organizational skills ability to ... while maintaining a high level of accuracy. Prior experience in HEDIS and overread review is essential for this role. Licenses/Certifications RN - Registered… 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...found. Correct errors identified through over-read process, including a re- review of charts that may contain similar errors. +… more
- US Tech Solutions (May, OK)
- **Job Title:** ** HEDIS Reviewer ** **Location: Remote** **Duration: 5+ months contract** **Job Description:** + Participates in the audit/overead of the medical ... an associate or bachelor degree is preferred but not required. Successful HEDIS review experience may be substituted for licensure. **About US Tech Solutions:**… more
- Molina Healthcare (Long Beach, CA)
- …in Southern California (LA/OC/IE Counties)** **Job Description** **Job Summary** Molina's HEDIS /Quality Improvement Sr. Medical Records Collector is a team member ... mail, electronic medical record system retrieval and direct onsite pick up, for the HEDIS projects. These team members help mentor other team members and take the… more
- Molina Healthcare (Long Beach, CA)
- **Job Description** **Job Summary** Molina's HEDIS /Quality Improvement Sr. Medical Records Collector is a team member with several years experience in working ... mail, electronic medical record system retrieval and direct onsite pick up, for the HEDIS projects. These team members help mentor other team members and take the… more
- Ventura County (Ventura, CA)
- …years of full-time experience in Case Management, Disease Management, Quality Assurance, HEDIS and/or Utilization Review . NECESSARY SPECIAL REQUIREMENTS + Must ... Utilization Management and tasks related to Healthcare Effectiveness Data and Information Set ( HEDIS ) as well as writing reports and analyses in line with the… 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...Care Management + 3 - 5 years in Utilization Review + 3 - 5 years in the Health… more