- Centers Plan for Healthy Living (Garden City, NY)
- HEDIS Reviewer 990 Stewart Ave, Garden City, NY 11530, USA Req #879 Monday, June 3, 2024 Centers Plan for Healthy Living's goal is to create the ultimate healthcare ... guidance and plans they need for healthy living. JOB SUMMARY: The HEDIS Reviewer is responsible for supporting the overall direction, coordination and implementation… more
- Molina Healthcare (Los Angeles, CA)
- …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
- Medical Mutual of Ohio (OH)
- …as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** ** HEDIS Analyst I** Supports corporate and departmental strategies and goals ... specifications for the annual Healthcare Effectiveness Data and Information Set ( HEDIS ) lifecycle processes for all lines of business (Commercial, Marketplace,… more
- Molina Healthcare (Louisville, KY)
- …team functions to conduct data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The ... lead role in 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. The Senior Abstractor will be… more
- Somatus (Mclean, VA)
- …and mental well-being + Community engagement opportunities + And more! The Sr. HEDIS Coordinator will perform the functions related to the outreach, collection, and ... entering of medical records and service data according to HEDIS / Somatus Technical Specifications. The primary focus of...Responsibilities + Coordinate, complete, and update management on all HEDIS processes and results. + Work with providers and… more
- Trinity Health (Columbus, OH)
- …of systems. + Manages the annual Healthcare Effectiveness Data and Information Set ( HEDIS ) audit and submission. **What we're looking for** : + Education: Bachelor's ... data processing for quality gap closures. + Previous experience with HEDIS , CAHPS and Medicare Advantage Star ratings, including technical specifications,… more
- State of Indiana (Indianapolis, IN)
- HEDIS & Quality Advisor Date Posted: Jun 7, 2024 Requisition ID: 444660 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career with the ... Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set ( HEDIS ), and other quality measures in our Medicaid programs, this role will… more
- CareOregon (Portland, OR)
- …or Wisconsin. Position Title: Cotiviti Applications System Administrator / HEDIS Analyst Exemption Status: Exempt Department: Information Systems Manager Title: ... flow Preferred: + 3+ years of Cotiviti experience + HEDIS exp to include Stars and/or HEDIS ...+ HEDIS exp to include Stars and/or HEDIS measures + Bachelor's degree in Computer Science, Information… more
- Molina Healthcare (AZ)
- …to one or more of these quality improvement functions: * Will create actionable HEDIS data and analytic insights. * Acts as a lead specialist to provide project-, ... (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
- Geisinger (Danville, PA)
- …and testing of applicable technology. + 5+ years of experience in running a HEDIS engine. + 5+ years of experience in analyzing HEDIS measure results ... at the data level, investigating compliance/non-compliance reasons + 5+ years of experience in supporting regulatory quality reporting. Work is typically performed in an office or remote environment. Accountable for satisfying all job specific obligations and… more
- Molina Healthcare (Laredo, TX)
- **JOB DESCRIPTION** **Job Summary** Molina's HEDIS /Quality Improvement Medical Records Collector will work collaboratively in outreaching to providers in order to ... system retrieval and direct onsite pick up, for the HEDIS projects. **Job Duties** + Under the direction of...regional lead, the Medical Records Collector supports the annual HEDIS audit and other HEDIS like audits,… more
- Centene Corporation (Indianapolis, IN)
- …provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, ... plan compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for...as a resource for the health plan peers on HEDIS measures, appropriate medical record documentation and appropriate coding.… more
- Centene Corporation (St. Louis, MO)
- …sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record ... deficiencies impacting plan compliance to meet State and Federal standards for HEDIS . + Under general guidance form Senior Quality Practice Advisors and management,… more
- Centene Corporation (Tallahassee, FL)
- …Quality Assurance (NCQA) and Healthcare Effectiveness Data and Information Set ( HEDIS ) preparation. *NOTE: Qualified candidates **MUST** reside in Florida. This role ... **Essential Responsibilities:** + Provide functional and technical knowledge for NCQA/ HEDIS across all plan departmental staff and deliver educational sessions… more
- The Cigna Group (Nashville, TN)
- …strategic objectives with tactical demands. We are seeking an experienced HEDIS (R) analyst who thrives on supporting sophisticated business challenges through ... technical skills to study and analyze systems needs and provide HEDIS (R)thought leadership and technical expertise across multiple disciplines, supporting our… more
- Highmark Health (Charleston, WV)
- …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
- Elevance Health (Cerritos, CA)
- …our organization, you'll have the chance to spearhead quality-enhancement campaigns ( HEDIS ) and launch initiatives that support STARS improvement. Your expertise and ... not limited to:** + Drives provider performance improvement for HEDIS , STARS, State Contract Quality & Pay for Performance/Withhold...+ Assume a key role in Quality Management Scorecards, HEDIS , HOS and CAHPS operations. + Develop strategic … 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
- Martin's Point Health Care (Portland, ME)
- …building and maintaining robust data infrastructure for Health Plan Risk Adjustment, HEDIS , Quality, and Clinical to support strategic analytics and reporting used ... and operations related to risk score and revenue projections, CMS submissions, HEDIS data submissions, population health, etc. + Reviews database architectures and… more
- Humana (Columbus, OH)
- …Provider Service Experience, Network Optimization, Clinical Services, Value-Based contracting, HEDIS and Risk Adjustment. Reporting to the Associate Director and/or ... management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as… more