- Adecco US, Inc. (Cumberland, RI)
- ** Now Hiring: Remote HEDIS Reviewer ** ** Pay:** $30-$32+/hr. ** Schedule:** Monday-Friday (Full-time) ** Remote | Laptop Provided** ** Quick Hits - ... ✅ **Ethernet connection required - NO Wi-Fi!** ** What You'll Do:** As a HEDIS Reviewer , you'll play a key role in improving care for health plan members by:… more
- Insight Global (Philadelphia, PA)
- …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/ HEDIS ... Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills and Requirements Previous HEDIS review experience Active RN License or… more
- Insight Global (Philadelphia, PA)
- …) Strong computer skills Ability to occasionally travel to local providers Previous HEDIS review experience or experience with Utilization Review , Quality, ... Job Description A client of Insight Globals is looking for HEDIS RNs or LPNs for a partially remote contract position in PA and NJ. PARTIALLY remote position… more
- Actalent (Sunrise, FL)
- Actalent is Hiring Multiple Remote HEDIS RN Abstractor Description: Position Purpose: Lead data collection and abstraction for company quality measures, ... standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS..., medical, quality audit, managed care, Medicare Work Environment: Remote Work Pay and Benefits The pay range for… more
- Adecco US, Inc. (Minneapolis, MN)
- Adecco Healthcare and Life Sciences is currently recruiting for Remote Clinical Quality LPNs with HEDIS experience. This is a telecommute role. Please read below ... Remote data mining in EHR systems to support HEDIS and STARs initiatives * Outreach to provider offices...or EHR navigation * 2+ years of medical chart review /data analysis experience * Strong written and verbal communication… more
- Molina Healthcare (Albuquerque, NM)
- …communicate risks and issues to stakeholders and leadership. * Create, review , and approve program documentation, including plans, reports, and records. * ... experience in risk adjustment and/or quality * 4+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems * 4+ years of… more
- Molina Healthcare (Scottsdale, AZ)
- …collaborative analytics and strategic teams to deliver proposed interventions for review and evaluation. + Communicates with the Molina Plan Senior Leadership ... **Preferred Experience** + 3+ years' experience with member/ provider ( HEDIS ) outreach and/or quality intervention or improvement studies (development,… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …as a Business Analyst! **This is an in-person position. This is not a remote role.** **This is not an IT position and requires population health and statistical ... Epic EMR reporting, and REDCap + Serve as MCAS HEDIS and AMP metric content expert with a robust...areas for process improvement and develop/implement solutions. + Lead review and writing descriptions of business needs and business… more
- Centene Corporation (Carson City, NV)
- …for Quality Assurance (NCQA) and Healthcare Effectiveness Data and Information Set ( HEDIS ) preparation. **_ Qualified candidates must reside in Nevada to be ... **Essential Responsibilities:** + Provide functional and technical knowledge for NCQA/ HEDIS across all plan departmental staff and deliver educational sessions… more
- Fallon Health (Worcester, MA)
- …care plan meetings with providers and office staff and may lead care plan review with providers and care team as applicable + Demonstrates positive customer service ... and Program policies and processes + Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member education, outreach, and… more
- Adecco US, Inc. (San Antonio, TX)
- …to request medical record data. . Act as a SME for data collection and HEDIS questions, asked by provider offices. . Review and abstract medical record data ... . Receive medical records directly to onsite office. . Review and track medical records received via mail. .... and track invoices received via mail. . Maintain remote access to the required EHR systems. . Data… more
- AmeriHealth Caritas (Manchester, NH)
- …**Responsibilities:** The Market Chief Medical Officer oversees all utilization review techniques, methods, administration, and implementation. They are directly ... CMO is accountable for ACFC quality initiatives to improve HEDIS and other quality ratings and will have substantial...experience as Associate Medical Director (or equivalent) or physician reviewer in a Managed Care Plan preferred. + Utilization… more
- Dignity Health (Bakersfield, CA)
- …years related HEDIS record collection and measures improvement with analytical review /evaluation and / or Quality Improvement. - Experience in data and chart ... **Responsibilities** This position is remote with a clear and current CA LVN...Liaison provides education and acts as a resource for HEDIS measures, appropriate medical record documentation and appropriate coding.… more
- CenterWell (Tallahassee, FL)
- …* Knowledge of HEDIS quality indicators Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. ... several nurse practitioners or physician assistants, including completing regular chart review , coordinating monthly meetings, and being readily available to help… more
- BJC HealthCare (St. Louis, MO)
- …of process and improvement results. + Supports effective medical record capture for HEDIS and quality measure medical record review and abstraction of ... project management skills will be utilized. This is a remote position, must be located in MO or IL....the expert in Healthcare Effectiveness Data and Information Set ( HEDIS ) and regulatory quality measures. The Senior Performance Measures… more
- Praxis Health (Eugene, OR)
- …patient populations. Certification Required:LPN or Highly Skilled MA Location:In-House Only (No Remote ) Schedule:Full-time, Monday - Friday, 8:00 AM - 5:00 PM Why ... with centralized PXH/Regence teams to drive performance in: + HEDIS metric tracking + Transitional Care Management (TCM) +...are included in the Interdisciplinary Team (IDT) agenda for review 3. High Emergency Room Utilization Oversight + Monitor… more
- AmeriHealth Caritas (Baton Rouge, LA)
- …initiatives. + Supports the quality improvement department with annual medical record review activities including HEDIS , and Clinical Practice Guidelines by ... This position is remote eligible for a Louisiana resident. ; **Responsibilities:**...may include participation in the development of medical record review tools, conducting training and testing of medical record… more
- AmeriHealth Caritas (Wilmington, DE)
- …provided by the care management platform and identifies Members with Care Gaps/ HEDIS -related health conditions and social determinants of health needs. The Care ... areas: Delaware County (PA)/Philadelphia, PA. The position is fully ** remote ** . The hours are **10:00 am EST to...guidelines; refer to the appropriate clinical team members for review as defined by the workflow; + Appropriately process… more
- CenterWell (Montgomery, AL)
- …defined by Clinical Leadership. + Meets with AMD about quality of care, review of outcome data, policy, procedure, and records issues. + Assures personal compliance ... Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. + Experience working in value-based care...official application on Humana's secure website. _*This is a remote position_ _**_ **_Must be able to work M-F… more
- Dignity Health (Bakersfield, CA)
- **Responsibilities** This position is remote /work from home** **within California** **.** This position will lead a team of dedicated LVNs/RNs in support of ... clinical and non-clinical quality management staff. - 3 years HEDIS measures reporting and experience in CMS Stars, P4P,...Value Based Payment Programs. - 3 years Medical record review project management. - Bachelor's degree or equivalent in… more