• HEDIS Reviewer II

    US Tech Solutions (May, OK)
    …the screenings. * Search for relevant HEDIS records from databases, review medical records using HEDIS technical specification criteria or ... collection, and review of medical records to abstract clinical information for HEDIS ...offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters… more
    US Tech Solutions (05/07/25)
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  • Associate Quality Practice Advisor

    Centene Corporation (Tallahassee, FL)
    …Social Work or related field. Candidate Experience: Required: 1+ year of experience in related HEDIS medical record review or quality improvement with ... of findings in identified databases and ensure accuracy in medical records for data collection, DE and...a managed care environment related to HEDIS record review , quality improvement, medical more
    Centene Corporation (06/08/25)
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  • DSNP Project/Program Manager

    BlueCross BlueShield of North Carolina (NC)
    …annual HEDIS functions such as: rate review , HEDIS roadmap, Medical Record Review (including overreading), analyze rates and trends, etc. + Other ... program contracts to ensure vendors meet service level agreements if applicable. + Review reports and records of activities to ensure progress is being… more
    BlueCross BlueShield of North Carolina (06/04/25)
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  • HEDIS Overreader Registered Nurse

    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
    Insight Global (04/01/25)
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  • HEDIS Registered Nurse or LPNs (Field…

    Insight Global (Philadelphia, PA)
    …providers Scan/Upload/Download medical records from onsite reviews daily Medical record abstraction into database from onsite visit, assigned remote ... from providers via fax, abstraction & entry of medical records assigned by a Clinical Quality... review experience or experience with Utilization Review , Quality, Medical Record auditing… more
    Insight Global (04/01/25)
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  • * HEDIS Reviewer III

    NTT DATA North America (IL)
    …Summary: Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting. Training will be ... the assignment. This position interprets relevant clinical criteria through review of medical records , annotates...offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters… more
    NTT DATA North America (04/02/25)
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  • Quality Improvement Project Manager

    Centene Corporation (Sacramento, CA)
    …to engage, recommend and support improved coding for direct impact on HEDIS data capture strategies in accordance with National Committee for Quality Assurance ... (NCQA) and Healthcare Effectiveness Data and Information Set ( HEDIS ) standards and specifications. Provide insight and make recommendations...as needed. + Design, run, and manage the data review process to ensure accuracy and integrity of data… more
    Centene Corporation (06/12/25)
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  • Quality Management Clinical Nurse - Facility Site…

    UCLA Health (Los Angeles, CA)
    …including inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health ... Key responsibilities include: + Travel to various clinic sites and schedule and conduct medical record and facility site audits + Conduct thorough facility site… more
    UCLA Health (06/11/25)
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  • Clinical Quality LPN

    Adecco US, Inc. (San Antonio, TX)
    …SME for data collection and HEDIS questions, asked by provider offices. . Review and abstract medical record data into appropriate application(s). . ... the Clinical Quality LPN** . Receive medical records directly to onsite office. . Review ...document findings. . Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS more
    Adecco US, Inc. (05/09/25)
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  • Clinical Quality LPN

    Adecco US, Inc. (Minneapolis, MN)
    …and STARs initiatives * Outreach to provider offices to request and follow up on medical records * Abstracting and entering chart data into systems such as ... is currently recruiting for Remote Clinical Quality LPNs with HEDIS experience. This is a telecommute role. Please read...provider outreach or EHR navigation * 2+ years of medical chart review /data analysis experience * Strong… more
    Adecco US, Inc. (05/09/25)
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  • Clinical Quality Liaison RN

    CommonSpirit Health Mountain Region (Centennial, CO)
    …action plans to address the needs and barriers in collaboration with providers. * Performs medical record review or audits as needed. * Document provider, ... + Required or equivalent work experience of 2 years related HEDIS record collection and measures improvement with analytical review /evaluation and / or… more
    CommonSpirit Health Mountain Region (04/26/25)
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  • Behavioral Health Liaison

    CVS Health (Tallahassee, FL)
    …care plan, and compliance with coordinated services. - Support record collection and review of case and medical records for behavioral health quality ... calls along with provider education initiatives that supports the development of HEDIS interventions to improve mental health wellness and outcomes. The Behavioral… more
    CVS Health (06/05/25)
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  • Utilization Review - Registered Nurse

    Community Health Systems (Naples, FL)
    …on performance improvement of the UR KPI's. Ensures proper and accurate medical record documentation. **Essential Functions** + Reviews new admissions using ... Primarily responsible for the collection and confirmation of accurate documentation in the Medical Record + Works with healthcare providers to ensure complete… more
    Community Health Systems (04/25/25)
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  • Population Health Clinical Quality and Risk…

    Dignity Health (Prescott, AZ)
    …+ Registered Nurse: AZ (RN:AZ) + 2 years related HEDIS record collection and measures improvement with analytical review /evaluation and/or Quality ... HEDIS measures, and ensure feedback is relayed on documenting appropriate medical record documentation and appropriate coding. + Assists in resolving… more
    Dignity Health (05/31/25)
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  • Quality Improvement Specialist II

    Centene Corporation (Springfield, IL)
    …of QI initiatives including but not limited to: access and availability studies, HEDIS abstraction forms, medical records /site reviews, member and physician ... data reporting needs, and project management. + Manage the HEDIS project to include assignment of nurses, adherence to...reliability audits + Design, run, and manage the data review process to ensure accuracy and integrity of data… more
    Centene Corporation (06/07/25)
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  • Clinical Quality and Risk Liaison LVN

    Dignity Health (Bakersfield, CA)
    …action plans to address the needs and barriers in collaboration with providers. - Performs medical record review or audits as needed. - Document provider, ... Liaison provides education and acts as a resource for HEDIS measures, appropriate medical record ...work experience of 2 years related HEDIS record collection and measures improvement with analytical review more
    Dignity Health (05/18/25)
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  • Government Business Quality Management Health Plan…

    Elevance Health (Metairie, LA)
    …Healthcare Effectiveness Data Information Set ( HEDIS ) improvement action plans, year-round medical record review , and over read processes. + Monitors ... of quality management to direct the clinical quality initiatives, including HEDIS and CAHPS quality improvement, NCQA accreditation and compliance with regulatory… more
    Elevance Health (06/10/25)
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  • Advanced Medical Support Assistant…

    Veterans Affairs, Veterans Health Administration (Portsmouth, VA)
    …automation duties such as faxing, scanning, and completing documentation to request medical records from community providers. Responsible for call responsiveness ... Summary This vacancy is for an Advanced Medical Support Assistant (AMSA) (Specialty and Primary Care...team (LPN, RN, Clinician/Provider, Social worker, Pharmacist, etc.). to review the clinic utilization by using various report clinic… more
    Veterans Affairs, Veterans Health Administration (06/13/25)
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  • Physician-Pediatrics

    Aspen Medical (Lackland, TX)
    …guidance and counseling to patients and families + The CP shall close out all medical records within a minimum of seventy-two (72) hours from the appointment ... of these results with the patient/parent in the electronic medical record . If the provider is not...record . If the provider is not available to review the results, the CP is required to assign… more
    Aspen Medical (05/09/25)
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  • EMR Assistant

    St. Mary's Healthcare (Amsterdam, NY)
    …and labels appropriately to alert provider for review and follow up. + Medical Records Updates: Scans, labels and uploads all new patient records . ... HIE (Health Information Exchanges), and ensures information is updated to existing medical record . + Patient Communication: Manages incoming calls/voicemail and… more
    St. Mary's Healthcare (05/20/25)
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