- NTT DATA North America (IL)
- HEDIS Reviewer - State of IL Position Summary: Participates in the collection and review of medical records to abstract clinical information for HEDIS ... the start of the assignment. This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data… more
- Centene Corporation (Oklahoma City, OK)
- …of the following areas: claims, provider data, member data, clinical data, HEDIS , pharmacy, external reporting + Extract, load, model, and reconcile large amounts ... of data across multiple system platforms and sources + Review data to determine operational impacts and needed actions;...analysis or data analysis experience or 2-4 years of HEDIS data analysis experience including measurement and rates impacted.… more
- Ventura County (Ventura, CA)
- …years of full-time experience in Case Management, Disease Management, Quality Assurance, HEDIS and/or Utilization Review . NECESSARY SPECIAL REQUIREMENTS + Must ... the Senior Medical Management Nurse is responsible for performing utilization review , case management, and quality improvement functions to ensure that members… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. ... + Participates in the orientation of new staff. Level III (in addition to Level II Essential Accountabilities) +...being met, such as NYS DOH, CMS, NCQA, and HEDIS , serving as internal auditor within the group. +… more
- CDPHP (Latham, NY)
- …for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. ... + Participates in the orientation of new staff. Level III (in addition to Level II Essential Accountabilities) +...being met, such as NYS DOH, CMS, NCQA, and HEDIS , serving as internal auditor within the group. +… more
- Queen's Health System (Honolulu, HI)
- …records via secured file transfer protocol (FTP) sites for quality and payor review of records ( HEDIS /Risk Adjustment/RAC). II. TYPICAL PHYSICAL DEMANDS: * ... business. * Upon request, releases records electronically for admitted patient's payor concurrent review of records. * Upon request, releases electronic copies of… more