• Director, Clinical Data Acquisition (HEDIS / Risk…

    Molina Healthcare (Columbus, GA)
    …operations that drive change. + Functions as key lead for clinical chart review /abstraction and team management. This includes qualitative analysis, reporting ... is responsible for the implementation, monitoring, and oversight of all chart collection for HEDIS, or HEDIS-like projects, Risk Adjustment, Risk Adjustment… more
    Molina Healthcare (08/21/25)
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  • Senior Overreader, HEDIS/Quality Improvement…

    Molina Healthcare (Atlanta, GA)
    …or feedback from the HEDIS audit. Makes recommendations based off of the audit and chart review . + Assists with ad hoc projects. + Participates in scheduled ... with ad hoc projects. **Job Duties** + Performs the role of the HEDIS medical record review overreader/auditor which includes ongoing review of records… more
    Molina Healthcare (08/21/25)
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  • HCC Risk Adjustment Coder - Full Time…

    Datavant (Atlanta, GA)
    …bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized ... severity of a patient's health status. **You will:** + Review , analyze, and code diagnostic information in a patient's..., analyze, and code diagnostic information in a patient's medical record based on client specific guidelines for the… more
    Datavant (08/26/25)
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  • Lead Abstractor, HEDIS/Quality Improvement…

    Molina Healthcare (Savannah, GA)
    …Duties** + Performs the lead role in the coordination and preparation of the HEDIS medical record review which includes ongoing review of records submitted ... supplemental data collection. The lead abstraction team will meet chart abstraction productivity standards, minimum over read standards, as...by providers and the annual HEDIS medical record review . + Leads meetings with… more
    Molina Healthcare (08/08/25)
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  • Auditor, Risk Adjustment ( Remote )

    Molina Healthcare (Macon, GA)
    …Qualifications** **Required Education** Associates degree. **Required Experience** 3 Years in coding and medical record chart review and experience with risk ... validation related activities, including, but not limited to: progress tracking, chart retrieval, file transmissions, and adherence to applicable timelines * Support… more
    Molina Healthcare (07/25/25)
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  • Manager, Clinical Data Acquisition ( Remote

    Molina Healthcare (Savannah, GA)
    …collection, reporting and monitoring process, including HEDIS, state-based measure reporting and medical record review . + Manages annual HEDIS data collection ... is performed for generated reports including performance measurement rates. + Manages medical record review and performance measurement reporting projects for… more
    Molina Healthcare (08/31/25)
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  • Inpatient Medical Coder - FT - Up to $5,000…

    Datavant (Atlanta, GA)
    …for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing ... ICD-9-CM, ICD-10-CM, and ICD-10-PCS codes + Accurately sequence and abstract medical codes from patient records, ensuring precision and adherence to documentation… more
    Datavant (06/25/25)
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  • Utilization Management Administration Coordinator…

    Humana (Atlanta, GA)
    …to the Value-Based segment partnering with CenterWell and Onehome. + Manages NLP's for chart reviews for the nursing team + Builds and pends authorizations for ... review + Responsible for inbound and outbound calls to...starting your FIRST day of employment. Benefits include: + Medical Benefits + Dental Benefits + Vision Benefits +… more
    Humana (08/23/25)
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  • Financial Systems Support Manager

    Truist (Atlanta, GA)
    …English (Required) **Work Shift:** 1st shift (United States of America) **Please review the following job description:** The Financial Systems Support Manager is ... for each of the financial management applications. + Oversee the general ledger chart of accounts governance, change management and end to end maintenance process in… more
    Truist (07/12/25)
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  • RN - Plan Case Manager

    PruittHealth (Atlanta, GA)
    …social and financial barriers in cooperation with the patient, PruittHealth Premier, and medical provider. Position will interact with members in both a home and ... patient based on a thorough history and clinical record review , including the attending physician's plan, the recommendations of...Ability to work independently and be self-motivated in a remote environment * Manage assigned case load as business… more
    PruittHealth (08/23/25)
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