- Molina Healthcare (NY)
- …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 (Buffalo, NY)
- …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 (Yonkers, NY)
- …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 (Rochester, NY)
- …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
- Highmark Health (Albany, NY)
- …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
- Centene Corporation (Queens, NY)
- …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
- CenterWell (Albany, NY)
- …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
- Molina Healthcare (Albany, NY)
- …to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success. * Partner with other teams to ensure data quality ... experience in risk adjustment and/or quality * 2+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems * 2+ years of… more
- Two95 International Inc. (New York, NY)
- …SPSS, and/or open-source including Python and R, or similar * Deep familiarity with HEDIS & CMS care quality measures; experience implementing both HEDIS and CMS ... measures using SAS and/or SQL * Attitude: A generally positive demeanor and outlook, works well with others and is community-minded, has a proactive leadership orientation, and enjoys contributing through work * Healthcare Domain Knowledge: Conceptual… more
- CVS Health (Albany, NY)
- …related role. + 2+ years of process improvement experience related to HEDIS measures. + In-depth knowledge of healthcare regulations, clinical operations, quality ... standards, and performance metrics. + Strong analytical and problem-solving skills, with the ability to interpret complex data sets and identify improvement opportunities. + Excellent communication, presentation and interpersonal skills to collaborate with and… more