- Molina Healthcare (Atlanta, GA)
- …and audits of the data collected and abstracted from medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The overreader ... projects. **Job Duties** + Performs the role of the HEDIS medical record review overreader/auditor which includes ongoing review...data entered by the abstraction team during the annual HEDIS medical record review as well as all other… more
- Molina Healthcare (Savannah, GA)
- …Lead Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The ... lead role in the coordination and preparation of the HEDIS medical record review which includes ongoing review of...review of records submitted by providers and the annual HEDIS medical record review. + Leads meetings with vendors… more
- Molina Healthcare (Columbus, GA)
- …for the implementation, monitoring, and oversight of all chart collection for HEDIS , or HEDIS -like projects, Risk Adjustment, Risk Adjustment Data Validation, ... management of training for all CDA team members as well as company HEDIS training, onboarding for CDA team members, vendor management for chart collection vendors,… more
- Molina Healthcare (Columbus, GA)
- …in one or more of the following critical QI functional areas: HEDIS Performance Measurement, which conducts data collection, reporting and monitoring for key ... with key departments within Molina and at Molina plans. + Leads HEDIS Performance Measurement programs using knowledge, skills and technical expertise in performance… more
- Molina Healthcare (GA)
- …education programs supporting Medicare Star Ratings improvement for Clinical HEDIS measures. Responsible for planning, developing and directing the implementation ... to ensure high level of performance across Medicare Stars clinical HEDIS programs. Leads enterprise partnership discussions and improvement opportunities across… more
- Centene Corporation (Augusta, GA)
- …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
- Elevance Health (Atlanta, GA)
- …who have experience in healthcare data, particularly in claims, case management, or HEDIS data. + A strong grasp of statistics, modeling, and their practical ... repeatable. + Preference will be given to candidates with experience in HEDIS /Quality measures data analytics. Please be advised that Elevance Health only accepts… more
- CVS Health (Atlanta, GA)
- …reporting requirements and contributes to the development and execution of HEDIS strategy to ensure compliance and optimize performance in quality measurement ... and qualitative data analysis to strategize and achieve operational targets for NCQA HEDIS and Medicare Stars * Provide analysis support for PIP reports to… more
- Highmark Health (Atlanta, GA)
- …methodologies and reporting/regulatory requirements and CMS Stars rating measures including HEDIS , CAHPS, Pharmacy, HOS, PQA, PQRS. + Supportdevelopment of the ... strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS , risk revenue value streams, and population health management. **Preferred** + 7… more
- CenterWell (Atlanta, GA)
- …opportunities. + Perform individual chart research as requested. + Collaborate with HEDIS leaders and champions to identify HEDIS gaps and deficiencies. ... + Participate in Payer calls/chart reviews. + Compile payer findings and assist with research. + Participate in payor meetings/discussions to ensure accurate data submission. **Use your skills to make an impact** **Required Qualifications:** + A minimum of… more