- US Tech Solutions (May, OK)
- …to assist in any way possible to complete the screenings. * Search for relevant HEDIS records from databases, review medical records using HEDIS technical ... Participates in the member and provider outreach, collection, and review of medical records to abstract clinical information for... of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to… more
- Queen's Health System (Honolulu, HI)
- …of 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… more
- HCA Healthcare (Salt Lake City, UT)
- …+ Working knowledge of electronic medical records, medical terminology, ICD-10, CPT II coding, HEDIS measures, and medical office processes (preferred) + ... Medical Home (PCMH), government programs (CMS), accountable care organizations (ACOs), HEDIS , and experience with payor cost sharing initiatives + Excellent oral… more
- HCA Healthcare (Overland Park, KS)
- …+ **Working knowledge of electronic medical records, medical terminology, ICD-10, CPT II coding, HEDIS measures, and/or medical office processes** + ... you to apply for our Care Coordinator WFH opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock… more
- Covenant Health Inc. (Knoxville, TN)
- …a proud member of Covenant Health! Position Summary: The RN Care Coordinator II is responsible for integrating evidenced based clinical practice into the patient ... resource and consultant to the health care team. The RN Care Coordinator II is responsible for promoting patient care coordination and quality through the… more
- Centene Corporation (Tallahassee, FL)
- …to leadership and/or customers + Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines + Support the design, ... mining, population health, and statistical modeling preferred **Quality:** Experience with HEDIS , NCQA, Medicare Star Rating System, QRS, or other quality measures… 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. ... + Performs other functions as assigned by management. Level II (in addition to Level I Essential Accountabilities) +...being met, such as NYS DOH, CMS, NCQA, and HEDIS , serving as internal auditor within the group. +… 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
- Excellus BlueCross BlueShield (Rochester, NY)
- …recommendations and/or decisions on Utilization or Case Management activities. Utilization review activities include: reviews of requests for broad range of medical ... clinical reviews with attending physicians or other providers to discuss review determinations with providers and external physicians. + Conduct clinical appeal… more
- CenterWell (Woodstock, GA)
- …achieve optimal patient outcomes and company initiatives, including Quality, HEDIS /STARs, AHCA, optimal patient scheduling, financial management, patient engagement, ... and expected outcomes collaboratively. *Focus on utilization management and review provider schedules to meet patient access goals, with...in the State of Florida will need ACHA Level II Background clearance. *Must have a valid driver's license… more