- Humana (Columbus, OH)
- …to optimize HEDIS data ingestion, EHR/HIE interoperability, supplemental data, and record review for the Medicaid line of business. + Supporting market level ... help us put health first** Humana is seeking a HEDIS Data and Reporting Lead to join the National...Information:** + **Workstyle:** Home. Home workstyle is defined as remote but will use Humana office space on an… more
- Highmark Health (Dover, DE)
- …job works with appropriate departments in the areas of compliance, process improvement, medical record review and coding, and member and provider satisfaction ... coding. Serves as a resource and educator regarding provider and office staff medical record documentation, federal and state standards including CMS and NCQA… more
- Centene Corporation (Omaha, NE)
- …Work or related field. Candidate Experience: Required: 1+ year of experience in related HEDIS medical record review or quality improvement with experience in ... Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record ...of findings in identified databases and ensure accuracy in medical records for data collection, DE and… more
- Molina Healthcare (AZ)
- …but not limited to, HEDIS , STARS, etc., the analysis of medical records data, etc. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or ... analytics, quality metric reporting and healthcare quality interventions.** **This position is remote , but only candidates in Arizona are being considered at this… more
- Centene Corporation (Dover, DE)
- …Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, appropriate medical record documentation and appropriate ... competitive benefits including a fresh perspective on workplace flexibility. ** Remote but must reside within Delaware or a surrounding...as a resource for the health plan peers on HEDIS measures, appropriate medical record … more
- Molina Healthcare (Albuquerque, NM)
- …but not limited to, HEDIS , STARS, etc., the analysis of medical records data, etc. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or ... year of experience in Medicare and in Medicaid. + HEDIS reporting or collection experience. + Experience developing and...(RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
- Two95 International Inc. (New York, NY)
- Job Title: Sr. Analytics Consultant Job type : Remote Work Type : 6+ Months Contract with extension Rate : $Market /Hour Requirements Job Description: Primary ... Python and R, or similar * Deep familiarity with HEDIS & CMS care quality measures; experience implementing both...of healthcare data, including data from EMR/EHR and/or from medical and pharmacy administrative claims; strong preference will be… more
- Actalent (Chattanooga, TN)
- … or supplemental data project experience is preferred, but not required * Experience in medical record review preferred * Some travel involved * Must be able to ... Description: The Supplemental Data Collection team will be collection medical data in preparation for the HEDIS ...nurse is responsible for retrieval, review, and abstraction of medical record data, required for multiple and… more
- Providence (Seattle, WA)
- …ROLE** The Senior Director Utilization Management & Denials - Administration is 100% remote . The role requires a broad knowledge and focus on Utilization Management ... utilization management, industry benchmarks, demonstrated regulatory requirement experience and medical necessity criteria. The role requires the ability to… more
- Healthfirst (New York, NY)
- …and office hour sessions with external stakeholders + Perform medical record reviews and data abstraction consistent with HEDIS measure technical ... external stakeholders during knowledge sharing events + Engage in medical record retrieval efforts for HEDIS... HEDIS and internal audit activities by ensuring medical records are accurately accounted for, scanned,… more
- Actalent (Chattanooga, TN)
- …in 2025. + The contract nurse is responsible for retrieval, review, and abstraction of medical record data, required for multiple and complex STARS and HEDIS ... + The Supplemental Data Collection team will be collection medical data in preparation for the HEDIS ...program tool. + This will include performing either on-site medical record review at physician offices or… more
- Apex Health Solutions (Houston, TX)
- …teams (eg s clinical implementation, analysis, research, support services, training, medical record retrieval projects). ESSENTIAL DUTIES: Coach Clinical ... Transformation. The PTS is responsible for providing on-site and remote assistance and /or education to clinicians, care teams...health plan goals are met as it relates to HEDIS /STARs and Risk Adjustment. This position coaches a practice… more
- Elevance Health (Woodland Hills, CA)
- …Effectiveness Data Information Set ( HEDIS ) improvement action plans, year round medical record review, and over read processes. + Monitors and reports ... Health Plan Director-California** **Location** : This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles of the… more
- Centerwell (Seneca, SC)
- …or GED + Bilingual + Hands-on professional Phlebotomy experience + Experience with Electronic Medical Records + Experience with HEDIS + Active Medical ... as discussing symptoms and gathering and inputting information into the electronic medical records system, taking vital signs, giving injections, performing… more
- Centene Corporation (Concord, NH)
- …appropriate HEDIS (Healthcare Effectiveness Data and Information Set) measures, medical record documentation guidelines and Member Experience measures. Acts ... plan providers regarding quality initiatives and key quality performance indicators. Shares HEDIS , CAHPS, HOS, Part D and Administrative Operations reports and gap… more
- Centene Corporation (Little Rock, AR)
- …appropriate HEDIS (Healthcare Effectiveness Data and Information Set) measures, medical record documentation guidelines and Member Experience measures. Acts ... plan providers regarding quality initiatives and key quality performance indicators. Shares HEDIS , CAHPS, HOS, Part D and Administrative Operations reports and gap… more
- Veterans Affairs, Veterans Health Administration (Columbia, SC)
- …order sets, documentation in CPRS, and other requirements of the VA's electronic medical record system. Demonstrates ability to function within a large complex ... that requires cooperation with multiple services, including community care, prosthetics service, medical administration, medical records , group medical … more
- Veterans Affairs, Veterans Health Administration (Las Vegas, NV)
- …order sets, documentation in CPRS, and other requirements of the VA's electronic medical record system. Demonstrates ability to function within a large complex ... that requires cooperation with multiple services, including community care, prosthetics service, medical administration, medical records , group medical … more
- MedKoder (Mandeville, LA)
- …resolution of coding projects as assigned + Document requested information from the medical record + Determine valid encounters including legibility and valid ... Position Location: 100% Remote Qualifications The Medical Coder provides...face to face encounters + Perform ongoing analysis of medical record charts for the appropriate coding… more
- Catholic Health Initiatives (Lexington, KY)
- …quality initiatives of the clinically integrated network. These functions include: Auditing medical records for qualifying documents that meet requirements to ... care, care coordination, disease management, managed care. Experience navigating electronic medical records and healthcare claims data. **Required Licensure and… more