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CVS Health

Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory/contractual requirements including outreach to members who are noncompliant in the designated outreach services. 
-Supports effective medical record capture for HEDIS medical record review and abstraction of supplemental data.
-Identifies potential resources and initiates collaboration with providers to improve member health outcomes and HEDIS measures.

Aledade - ​

100% remote position –

• Familiar with HEDIS quality measures and quality improvement approaches 

• Relevant competencies include developing and maintaining customer relationships, analytical problem solving, project management, effective written and verbal communication, and strategic insight

• Familiar with quality measures & quality performance initiatives 

• Must be results-oriented with the ability to prioritize and manage multiple projects simultaneously to consistently meet deadlines and client expectations

Bluestone Staffing Solutions

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100% remote position – candidate can be located anywhere in US to qualify for the position
– Work Shift: 8am – 5pm CST
– Must have requirements for the role: Medical records, and Call Center/Customer Service experience . Seeking multitaskers and go getters

– Looking for candidates who are eager to learn and work hard.
– Day to day responsibilities: Provider outreach to make phone calls, naming medical records, researching claims to verify that the client is working with the correct Provider

Solomon Page

 

Activities to support, and collection/abstraction of medical records to support HEDIS/QARR project for Medicare/Medicaid managed care organization operating in the Tri-State New York region IRR Audit scores: 97% or higher
Contacting primary and specialty care offices for record collection and gathering data. Sending Member Rosters using secure fax and Secure Email according to company complaint HIPAA standards
Abstraction/collection/data entry

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UnitedHealth  Group

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Serves as subject matter expert (SME) for assigned HEDIS/State Measures, preventive health topics, leads efforts with clinical team to research and design educational materials for use in practitioner offices; serves as liaison with key vendors supporting HEDIS/State Measures; consults with vendors to design and implement initiatives to innovate and then improve HEDIS/State Measure rates.

Audacious Inquiry -

with clinical quality measures and payer needs such as STARS and HEDIS reporting

VillageMD -

understanding of HEDIS, Stars, and MIPs Proficient computer skills with Microsoft

Molina Health

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In collaboration with Quality Improvement (QI) management, the Senior Analyst, HEDIS/Quality Reporting develops
and provides reports and cost-benefit analysis tools to meet QI requirements and uses automated software tools and
processes to help streamline activities and improve data/analytics for the quality team.

Collaborates with other department staff to convert HEDIS data sources for use in HEDIS reporting as needed.

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Prominence Health Plan

 

Under the direction of the Director of Performance Improvement, the Manager of HEDIS Program will be responsible for HEDIS program management within the Performance Improvement.

This position will oversee the implementation of the HEDIS operations, reporting, and strategy, with an emphasis on initiatives that improve the plan’s quality performance programs.

Primary responsibilities will be ownership of the HEDIS Program

 Anthem, Inc. -

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. Core Responsibilities of this position include: Ensuring the collection, production, analysis and reporting of HEDIS measures and related data. Targeting improved quality and health outcomes using computational statistics. Modeling clinical events from multiple sources of data.

enVista LLC -

A consulting agency is in need of a Remote Consulting Customer Success Leader in Carmel. Must be able to: Delivering and communicating ROI for our clients Quarterbacking experiences by various cross-functional teams Addressing escalated client issues Applicants must meet the following

Equity Staffing Group -

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HEDIS Administrative Assistant- Remote Equity Staffing is looking for several Telecommute HEDIS Administrative Assistants. This is a temporary position with a Fortune 100 organization. Our client serves more than 85 million people and has a reputation for bold ideas. If you enjoy working with

Sentara Healthcare -

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We are also seeking candidates with experience with HEDIS or Medicare STARS experience. . Required Education. Bachelor's Level Degree. Experience. Required: Data Analysis - 1 year, Financial Analysis - 1 year, Information Technology - 1 year, Statistics - 1 year.

AvMed -

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This position is responsible for providing leadership, coordination and management of HEDIS, HOS and Stars for measures as assigned and Quality Improvement projects and collecting, analyzing, interpreting 

Health Data Vision, Inc. -

A health information technology company has an open position for a Virtual HEDIS Abstractor. . Candidates will be responsible for the following: Applying appropriate codes to indicate any issues with documented findings.

MedKoder, L.L.C. -

High School diploma required. . Associates or BS degree preferred. . Minimum of three years of coding experience (recent hands on production). Must have at least 3 years of specialized experience in Medicare Risk Adjustment disciplines- such as HCC,CCC HEDIS. Auditing experience required.

 Beacon Health Options -

g. HEDIS, QARR, Star Measures, Quality Incentive Measures, and various regulatory reports. Accreditation experience is required. What Makes Us Different? Here, it's not just a job - it's an opportunity to change lives. Our employees are learners, innovators and original thinkers.

Arcadia  Anywhere - USA

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100% remote position –

• Maintain knowledge of industry quality measures (UDS, HEDIS, eCQM, etc) as well as understanding how clinical data may impact quality measures

• You will be responsible to develop measures accurately and to the specification and communicate to internal teams if measures may deviate and any limitations in the measure code

• Become an expert in quality measure specifications and understanding; work directly across the Arcadia organization to answer any questions on specifications or measure logic

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​Anthem

• delegation requirements in accordance with local, state, federal and NCQA requirements.

• Represent Quality Department at Health Plan’s or other state/client specific meetings where current quality activities including outcomes are discussed or presented.

• Contribute to NCQA accreditation activities and conduct research, reporting, and data analysis focusing on NCQA accreditation activities to ensure ongoing compliance with the accreditation standards.

BlueCross BlueShield Association

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• Manages and provides leadership for FEP Clinical Data Integration. Activities with primary focus on HEDIS processes and outcomes. Manages clinical data and governance initiatives in support of. Integrated Care Management and other FEP departments. Performs various assessments and identifies opportunities for process/systems improvement.

• Oversees and significantly contributes to the execution of complex projects and deliverables that cross many functional boundaries.

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Universal Health services, Inc

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The HEDIS Chart Abstractor will possess basic clinical and healthcare knowledge, basic knowledge of NCQA HEDIS abstracting guidelines, with the ability to access medical records (electronic and paper).  The Abstractor will be able to accurately identify required data and information, extract and organize this data and enter into a HEDIS software database.

Bluestone Staffing Solutions

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HEDIS Specialist I CONTRACTOR Long Beach, CA Administrative Reference Code: 4547 Position Title: HEDIS Specialist I Location... is preferred, however not required HEDIS experience is required for the role

UnitedHealth Group -

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methodology such as Waterfall or Agile Knowledge of HEDIS Careers with Optum.... Job Keywords: SQL, Oracle, BI, Tableau, MicroStrategy, HEDIS, SDLC, Las Vegas

LHC Group

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Experience with multiple Electronic Health Records (EHRs) preferred.
• Healthcare experience desired.
• Knowledge of HEDIS, Medicare, and ACO practice management preferred.

Skill Requirements

• Must be hands-on with great attention to detail.
• Must be accountable
• Must have strong drive to develop him/herself while learning Imperium’s business model.
• Strong organizational skills.
• Excellent written and verbal communication skills.

myKelly.Jobs

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Conduct internal record reviews and audits, including medical records.

• Review records to ensure they are complete, accurate and compliant with standards Initiate SOP revisions to ensure they are current and validated and support continuous improvement

• Develop and enhance documentation, tracking tools and process flows for quality monitoring activities to comply with current regulations and standards​

Arkansas - Remote

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The Member Experience Program Manager will focus on improving the plan’s Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores through these independently developed initiatives and outreaches while also serving as a resource for other program implementation. They will also effectively collaborate with others on improving performance in HOS measures.

 Molina Healthcare, Inc. -

Sr. . Abstractor, HEDIS/Quality Improvement - Remote in Ohio - (2003847) Primary Location: US-CA-Long Beach-Remote Employees. Job: Quality Assurance. Organization: Corporate. 

Anthem, Inc. -

 

Primary duties may include, but are not limited to: Oversees quality and performance improvement projects and HEDIS activities within the region. . Uses QI techniques (PDSA, root cause analysis) to identify opportunities for improvement.

Equity Staffing Group -

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Senior Hedis Project Coordinator- Remote Equity Staffing is looking for several HEDIS Project Coordinators. This is a temporary position with a Fortune 100 organization. Our client serves more than 85 million people and has a reputation for bold ideas. If you enjoy working with energetic people

Aegis Medical Group

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• Checking PCP schedules weekly and reviewing patient’s charts for any outstanding HEDIS measures.

• Creating or modifying HEDIS ENCOUNTERS in patients’ charts to communicate with Physicians and Medical Staff.

• Reviewing or creating various reports using Microsoft Excel. Ability to manipulate spreadsheets using features: filtering, sorting, grouping,

All Care To You, LLC

San Jose, CA 60,000 - 120,000

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Complete new provider orientation for all applicable product lines.

• Conducts site visits to service providers, resolve issues, educate staff/providers on policies, collect credentialing information, and review HEDIS information.

• Achieves call reach and frequency goals to establish consistent and strong relationship with provider offices.

Sentara Healthcare -

. We are also seeking candidates with experience with HEDIS or Medicare STARS experience. . Required Education. Bachelor's Level Degree. Experience. Required: Data Analysis - 1 year, Financial Analysis - 1 year, Information Technology - 1 year, Statistics - 1 year.

Centene Corporation 

Augusta, GA

Under general guidance form Senior Quality Practice Advisors and management, educates community physician and small provider practices in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements.