- Sharp HealthCare (San Diego, CA)
- …process. + Participates in risk management, 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. + Participates in the… more
- CVS Health (Frankfort, KY)
- …on solutions for emergent issues. - Supports effective medical record capture for HEDIS (R) medical record review and abstraction of supplemental data **Required ... any setting - 1 years of Medicaid experience and/or 1+ years of HEDIS medical record abstraction experience - Subject Matter Expert in Healthcare Effectiveness Data… more
- Community Based Care of Brevard, Inc. (Orlando, FL)
- …and ensure that the enrollee attends a seven (7) day follow up appointment. . HEDIS Care Gap Reports: Review of health and wellness reports (ie, HEDIS ... Multi-Disciplinary Staffings, monitoring Baker Act admissions and compliance with HEDIS measures associated with post-discharge activities, and providing clinical… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …complete clinical quality reporting across multiple programs including Medicare CQMs, HEDIS , Stars, and Commercial payer quality initiatives. This role is ... meet Medicare and Commercial payer quality reporting requirements. + Facilitates the generation, review , and validation of QRDA Category I and III and CCDA reports… more
- NTT DATA North America (Lincoln, RI)
- …multi-task to accomplish workload efficiently **JOB QUALIFICATIONS** + 2+ years of experience of HEDIS medical records review + 2+ years in medical terminology + ... who work here. NTT DATA Services currently seeks a ** HEDIS Administrative Assistant** to join our team for a...**In this role you will be responsible for:** + Review , abstract, and data enter all medical records and… more
- CenterWell (Jacksonville, FL)
- …quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities in care, ensuring clinical assessments ... experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS , meeting local and organizational goals + Personally deliver high-quality primary… more
- Insight Global (Hartford, CT)
- …to support organizational reporting and accreditation efforts, specifically around HEDIS accreditation. This role involves translating Quality Assurance (QA) ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/. Skills and… more
- Trinity Health (Boise, ID)
- …Quality Performance Improvement initiatives (Gaps In Care Closure) focused on Quality measures ( HEDIS ). + This position will be primarily located at one of our ... PHMA work includes supporting system-wide quality performance goals for HEDIS and STAR measures. This role reports to the...payor lists for open gaps in care, completing chart review for documentation of gap closure, and potentially some… more
- CenterWell (Tallahassee, FL)
- …Coding Collaboration:** + Perform Quality Assurance on post-visit reviews. + Review the encounter for potential missed opportunities. + Address nonbillable services ... Perform individual chart research as requested. + Collaborate with HEDIS leaders and champions to identify HEDIS ...with HEDIS leaders and champions to identify HEDIS gaps and deficiencies. + Participate in Payer calls/chart… 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 ... communicate risks and issues to stakeholders and leadership. * Create, review , and approve program documentation, including plans, reports, and records. *… more