- Centene Corporation (Austin, TX)
- …Role focuses on Inter-Rater Reliability ( IRR) or Secondary Overreads for HEDIS . **Position Purpose:** Support the development and maintenance of quality improvement ... related projects specific to HEDIS Hybrid Operations. The position exists to support the...health plans in the clinical aspect of medical record review . + Train providers, health plans and staff in… more
- Humana (Denver, CO)
- …plan operations. **Location:** Remote or if near Louisville hybrid The Lead for HEDIS Controlling Blood Pressure is responsible for the advancement of the initiative ... operational execution and performance oversight in effort to achieve high HEDIS condition management Stars performance targets. This individual will define… more
- Humana (Boise, ID)
- …plan operations. Location: remote or if in Louisville area then hybrid The HEDIS Condition Management team is seeking a passionate and organized teammate to ... accelerate measure improvement efforts to improve HEDIS performance. The Senior Professional strategically identifies, develops, and implements programs that… more
- Excellus BlueCross BlueShield (Utica, NY)
- …limited to requesting and retrieving medical records from providers to the plan for review and for Risk Adjustment Validation Audits (RADV). * Acts as a preceptor to ... new employees during the orientation process. Functions as a resource to existing staff for projects and daily work. Facilitates ongoing training for optimal staff functioning. * Proposes and develops new desk level procedures (DLP's) and policies and… more
- Molina Healthcare (Lexington, KY)
- …of the performance measurement data collection, reporting and monitoring process, including HEDIS , state-based measure reporting and medical record review . + ... activities. Responsibilities include responding to RFP(s) as needed, development of the HEDIS measures matrix, HEDIS work plans, and all product timelines.… more
- CVS Health (Columbus, OH)
- …in the designated outreach services + Supports effective medical record capture for HEDIS (R) medical record review and abstraction of supplemental data + Public ... address care gaps, educational needs, and record collection for HEDIS (R) leading to positive outcomes for our members Join...assists in answering questions regarding all facets of the HEDIS (R) process, such as how to submit records to… more
- CVS Health (Trenton, NJ)
- …in the designated outreach services - Supports effective medical record capture for HEDIS (R) medical record review and abstraction of supplemental data - Public ... assists in answering questions regarding all facets of the HEDIS (R) process, such as how to submit records to...Analyst/Outreach Coordinator will be the subject matter expert regarding HEDIS measures as well as help devise a plan… more
- UCLA Health (Los Angeles, CA)
- …facilitate appropriate Health Education opportunities. Additionally, you will performs HEDIS related activities, Pay for Performance activities, Provider Access and ... inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health plan and/or… more
- Highmark Health (Pittsburgh, PA)
- …Drives efficient operational functions to achieve established Quality measures, STARS and HEDIS performance ratings. Directs and manages team of ~75 employees that ... ensure complete / accurate assessment and documentation of member profile. + HEDIS Abstraction:Primary liaison with Highmark's Quality/ Stars team for retrieval and… more
- Sharp HealthCare (San Diego, CA)
- …in risk management reviews. + Assists in pharmacy utilization management, catastrophic case review , outreach programs, HEDIS reporting, site visit review ... achieve selected utilization/cost and quality outcomes. + Participates in policy review , performs analysis and makes recommendations for updating current polices to… more