- UNIVERSITY HEALTH (San Antonio, TX)
- …(NCQA) that promotes Healthcare Effectiveness Data and Information Set ( HEDIS ) metrics, Utilization Review Accreditation Commission (URAC), and the Joint ... Commission (TJC). EDUCATION AND EXPERIENCE Associate's Degree is required; Associate's degree in Health Information Management and/or Bachelor's degree is preferred. Completion of a coding program is required. [Note: Completion of a coding program from the… 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 ... and data entry activities **Education:** High school diploma or GED **Skills:** HEDIS , data entry **About US Tech Solutions:** US Tech Solutions is a… more
- Molina Healthcare (TX)
- …Molina's Quality Reporting team. Designs and develops reporting solutions to assist HEDIS Outbound, Inbound extracts, Data Ingestions, Dashboards, Reports & ... HEDIS Domain - such as Measure analysis/reconciliation on data wrt measure specifications. * 5+ Years of experience...* 5+ Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking,… more
- Molina Healthcare (Omaha, NE)
- … HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. **Job Qualifications** **REQU** **I** **RED ED** **U** **C** ... data collected and abstracted from medical records for HEDIS projects, HEDIS like projects and supplemental...projects. **Job Duties** + Performs the role of the HEDIS medical record review overreader/auditor which includes… more
- Molina Healthcare (Imperial Beach, CA)
- … HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. **Job Qualifications** **REQUIRED EDUCATION:** High School Diploma ... data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental...minimum over read standards. **Job Duties** + Coordinates the HEDIS medical record review which includes ongoing… more
- Providence (WA)
- …specifications for the Healthcare Effectiveness and Data Information Set ( HEDIS ) program. Audits include review of outpatient medical records, hospital ... **Description** The on-call HEDIS Clinical Audit Coordinator is responsible for conducting...with health plans, project management, program evaluation, team facilitation, data analysis, and/or case review . **Why Join… more
- Centene Corporation (Oklahoma City, OK)
- …large amounts of data across multiple system platforms and sources + Review data to determine operational impacts and needed actions; elevate issues, trends, ... statistical analysis or data analysis experience or 2-4 years of HEDIS data analysis experience including measurement and rates impacted. Expert in Power BI… more
- Martin's Point Health Care (Portland, ME)
- …+ Demonstrated knowledge of data collection, medical record review , and data extraction. + NCQA and HEDIS Experience. + Project management experience in ... procedures. + Develops and implements strategies to validate supplemental data sources used in HEDIS operations, ensuring...with regulatory requirements. + Maintains a robust medical record review program to assess the quality of care provided… more
- Ventura County (Ventura, CA)
- …preventing diseases, and maintaining well-being; + Assumes responsibilities related to HEDIS , including data collection, reporting, and ensuring compliance with ... years of full-time experience in Case Management, Disease Management, Quality Assurance, HEDIS and/or Utilization Review . NECESSARY SPECIAL REQUIREMENTS + Must… more
- NTT DATA North America (IL)
- HEDIS Reviewer - State of IL Position...medical records, annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS ... Summary: Participates in the collection and review of medical records to abstract clinical... of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to… more
- The Cigna Group (Bloomfield, CT)
- …allow Cigna to benchmark against competitors, and drive improvements in patient outcomes. This data will feed into HEDIS (healthcare effectiveness data and ... + Network and build connections with partner teams such as Data Engineering, Interoperability, Clinical Initiatives, and HEDIS Operations **Qualifications:**… more
- Centene Corporation (Lincoln, NE)
- …+ Manage all aspects of HEDIS improvement activities, including outreach, incentives, data integrity and chart review . + Responsible for insuring no loss of ... of performance standards and monitoring of performance standards. + Review and implement new technological tools and processes and...to support the expansion of alternative payment models using HEDIS data . + Performs other duties as… more
- Baylor Scott & White Health (Lincoln, NE)
- …on reliability of resulting data . Medical record abstraction for NCQA HEDIS medical record review project (January-May). Clearly document information to ... and tracking issues. Performs and assists in studies and initiatives related to HEDIS /Medical Data Collections, Scott and White Health Plan (SWHP) QI studies… more
- Centene Corporation (Lansing, MI)
- …large amounts of data across multiple system platforms and sources + Review data to determine operational impacts and needed actions; elevate issues, trends, ... or some of the following areas: claims, provider data , member data , clinical data , HEDIS , pharmacy, external reporting + Extract, load, model, and… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary:** The HEDIS Network Analyst will support CCA's ability to meet and surpass critical Quality ... **Essential Duties & Responsibilities:** + **Conduct weekly tracking of Quality/ HEDIS metrics, specifically focused on Initiation and Engagement of Alcohol or… more
- Molina Healthcare (Rio Rancho, NM)
- …such interventions. + Assist retrospective HEDIS rate tracking and supplemental data impact reporting. + Develop Medical Record Review project reporting to ... Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS...+ 3+ Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking,… more
- Centene Corporation (Phoenix, AZ)
- …sentinel events related to quality of care issues. + Audit medical records, review administrative claims and analyze data and interventions for quality ... including a fresh perspective on workplace flexibility. **Position Purpose:** Conduct review of delegated entities for compliance with quality, service performance… more
- General Dynamics Information Technology (Falls Church, VA)
- …include knowledge of Joint Commission standards, Infection Control and other quality measures. + Review raw and synthesized data ( HEDIS , ORYX, TJC, NPIC, ... to Obtain:** Secret **Public Trust/Other Required:** None **Job Family:** Data Science and Data Engineering **Skills:** ...and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings… more
- Trinity Health (Boise, ID)
- …analysis and/or project management, preferably in health care. + **Experience with HEDIS (Healthcare Effectiveness Data and Information Set), PQRS (Physician ... role requires attention to detail, intermediate comfort with using excel, healthcare data analysis experience, ability to use critical thinking skills, and leverage… more
- Avera (Sioux Falls, SD)
- …for activities focused around Risk Adjustment (RA) initiatives and Healthcare Effectiveness Data Information Sets ( HEDIS ). The Quality and Risk Adjustment ... meetings and webinars, in regards to Risk Adjustment and HEDIS . + Supports annual RADV (Risk Adjustment Data...+ Identifies opportunities for synergies related to medical record review and manages the medical record request process for… more
