- ProKatchers (Bowling Green, NY)
- Position: HEDIS Quality Reviewer / Clinical Quality Reviewer Duration: 03+ months contract (Possible extension) Location: Manhattan, NY 10004 Shift :: 9:00am- ... summarize and report findings. Additionally, participation in the annual HEDIS and QARR hybrid medical record review ...medical records (electronic and paper-based) Serve as a final reviewer of HEDIS and QARR records. Other… more
- Centers Plan for Healthy Living (Garden City, NY)
- HEDIS Reviewer 990 Stewart Ave, Garden City, NY 11530, USA Req #879 Monday, April 29, 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
- Elevance Health (New York, NY)
- …+ Use tools to enable HEDIS to measure deep dives and data quality review to improve HEDIS Ratings. **Minimum Requirements:** + Requires a BS/BA degree in a ... to analyze HEDIS results. + Advanced knowledge of HEDIS specifications, medical record review process including the sample and chase creation, and data… more
- Centene Corporation (New York, NY)
- …of the following areas: claims, provider data, member data, clinical data, HEDIS , pharmacy, external reporting. + Extract, load, model, and reconcile large amounts ... of data across multiple system platforms and sources. + Review data to determine operational impacts and needed actions; elevate issues, trends, areas for… more
- Healthfirst (New York, NY)
- …projects related to improving quality measures such as conducting comprehensive medication review through a hybrid MTM approach and supporting efforts to improve ... HEDIS and QARR measures as related to medication adherence and member behaviors. Job DescriptionDuties & Responsibilities: Knowledge of quality measures related to… more
- Elevance Health (Manhattan, NY)
- …must be in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base ... and knowledge highly preferred + Proven ability to analyze medical cost trends. + HEDIS , STARS performance and Quality experience + Health plan or payor experience +… more
- Elevance Health (New York, NY)
- …contract requirements for regulatory reporting, encounter reporting, quality audits, HEDIS /EPSDT, state relationships for DSNP, and other contract requirements. ... community, and catcher's mitt strategies. + Support internal Business Operating Review leadership presentations + Hire, train, coach, counsel, and evaluate… more
