- Molina Healthcare (Vancouver, WA)
- …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 (Spokane, WA)
- …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 (WA)
- …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 (Everett, WA)
- …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 (Spokane, WA)
- …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
- Highmark Health (Olympia, WA)
- …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 (Olympia, WA)
- …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 (Bellevue, WA)
- …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
- Molina Healthcare (Everett, WA)
- …policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS , Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, ... capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease management, and evidence-based guidelines. + Experience in Utilization/Quality Program management +… more
- Pacific Medical Centers (Renton, WA)
- …and reporting from a warehouse type database. + Experience with HEDIS reporting desired. + Experience with GE/Centricity/IDX healthcare software application desired. ... + Clinic setting operations experience highly desirable as complementary experience to the above. **Why Join Providence?** Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving… more