- Molina Healthcare (St. Petersburg, FL)
- …which includes ongoing review of records submitted by providers and the annual HEDIS medical record review . + Leads meetings with vendors for the ... Improvement Lead Abstractor conducts data collection and abstraction of medical records for HEDIS projects,...lead role in the coordination and preparation of the HEDIS medical record review… more
- Centene Corporation (Spring Hill, FL)
- …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
- 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
- CVS Health (Tallahassee, FL)
- …care of patients with severe, complex, and/or treatment resistant illnesses through peer review and educational interventions. * Work with medical director teams ... focusing on inpatient care management, clinical coverage review , member appeals clinical review , ...multiple stakeholders. * Help achieve or exceed all applicable HEDIS , Stars and local state performance targets and goals… more
- CenterWell (Tallahassee, FL)
- … Medical Coding Professional extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical ... and Advanced Practice Providers) to ensure the documentation within medical records supports diagnostic and procedural coding. **Relationship/Concierge… more
- Prime Therapeutics (Tallahassee, FL)
- …to support the Centers for Medicare & Medicaid Services (CMS) Star and HEDIS quality measure programs, including but not limited to: Medication Therapy Management ... qualified members' medications and disease states related to the Star and HEDIS quality measures programs and processes. **Responsibilities** + Receive inbound and… more
- AdventHealth (Sebring, FL)
- …Physician Attestation Form (PAF) or Attestation prior to the patients appointment. Perform HEDIS medical record reviews, data collection, chart abstractions, ... reporting, and analysis. Coordinate and perform onsite medical record reviews and medical...record collection at provider offices to support optimum MRA/ HEDIS and quality metric reporting. Identify patients overdue for… more
- Elevance Health (Miami, FL)
- …to ensure full accurate and appropriate diagnosis, documentation, coding and care. will review all provider visit medical encounters and apply most appropriate ... + Liaison to coding team. + Participate in peer review of medical documentation for completed visit...CMS guidelines including Risk Adjustment payment model, STARS and HEDIS highly preferred. + Clinical review experience.… more
- CenterWell (Port Orange, FL)
- …on outpatient medicine, continuity of care, health maintenance, and disease prevention. Keeps a medical history and medical records . Refers the patient to ... of care, health maintenance, and disease prevention. Keeps a medical history and medical records ....displaying a professional and approachable demeanor. . Completes all medical record documentation in a timely manner… more
- CenterWell (Daytona Beach, FL)
- …on outpatient medicine, continuity of care, health maintenance, and disease prevention. Keeps a medical history and medical records . Refers the patient to ... displaying a professional and approachable demeanor. . Completes all medical record documentation in a timely manner...Leadership. . Meets with RMD about quality of care, review of outcome data, policy, procedure and records… more