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Hedis Reviewer Iii Jobs

Hedis Coordinator - Remote
By ASK Consulting At ,
100 % Remote - candidates must have reliable;
Expiry Date: 15 September 2023
Process medical records received for HEDIS and other related projects
Index medical records into systems
Call provider offices to confirm medical record contact information
Fax medical record requests to provider offices
Medical Reviewer Iii Jobs
By BlueCross BlueShield of South Carolina At , Nashville, 37214
Assists with special projects and specialty duties/responsibilities as assigned by Management.
Continuing education funds for additional certifications and certification renewal.
Provides education to non-medical staff through discussions, team meetings, classroom participation and feedback.
FOR PALMETTO GBA (CO. 033) ONLY: two years clinical experience plus two years utilization/medical review, quality assurance, OR home health experience.
Knowledge of specific criteria/protocol sets and the use of the same.
Working knowledge of word processing software.
Hedis Medical Records Specialist (Hedis Abstractor)
By LanceSoft, Inc. At United States
• Proven organizational and time management skills including the ability to meet required deadlines
•Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities"
"• 0-3 years of experience auditing and abstracting medical records required
• Medical knowledge/terminology is required.
• Excellent verbal and written communication skills – clear, concise and appropriate.
• Exceptional attention to detail and excellent analytical, investigation, and problem-solving skills
Rn Medical Reviewer Iii - Cgs Administrators
By CGS Administrators, LLC At Knoxville Metropolitan Area, United States
Assist with special projects and specialty duties/responsibilities as assigned by Management.
Utilization Review or Case Management experience.
Provide education to non-medical staff through discussions, team meetings, classroom participation and feedback.
Knowledge of specific criteria/protocol sets and the use of the same.
Working knowledge of word processing software.
Demonstrated customer service and organizational skills.
Rn Medical Reviewer Iii - Cgs Administrators
By CGS Administrators, LLC At Columbia, SC, United States
Assist with special projects and specialty duties/responsibilities as assigned by Management.
Provide education to non-medical staff through discussions, team meetings, classroom participation and feedback.
Knowledge of specific criteria/protocol sets and the use of the same.
Working knowledge of word processing software.
Demonstrated customer service and organizational skills.
Demonstrated oral and written communication skills.
Project Manager Iii (Healthcare, Hedis) - Remote
By RemoteWorker US At Greensboro, NC, United States
4+ years of project management and implementation or program management experience.
Proficient with MS Office applications and project management tools.
Strong knowledge of healthcare quality measures, Medicare STARS, Medicaid Quality Rate System, regulatory reporting requirements, and business intelligence solutions highly preferred.
Experience working with and leading diverse groups and matrix managed environments.
Bachelor's degree in Business Administration, Healthcare Administration, related field, or equivalent experience. Master's degree preferred.
PMP certification highly preferred .
Rn Medical Reviewer Iii - Cgs Administrators, Llc-1
By BlueCross BlueShield of South Carolina At Columbia, SC, United States
Assist with special projects and specialty duties/responsibilities as assigned by Management.
Provide education to non-medical staff through discussions, team meetings, classroom participation and feedback.
Knowledge of specific criteria/protocol sets and the use of the same.
Working knowledge of word processing software.
Demonstrated customer service and organizational skills.
Demonstrated oral and written communication skills.
Rn Medical Reviewer Iii
By BlueCross BlueShield of South Carolina At , , Tn
Assist with special projects and specialty duties/responsibilities as assigned by Management.
Provide education to non-medical staff through discussions, team meetings, classroom participation and feedback.
Knowledge of specific criteria/protocol sets and the use of the same.
Working knowledge of word processing software.
Demonstrated customer service and organizational skills.
Demonstrated oral and written communication skills.
Quality Coordinator (Hedis) Jobs
By NYC Health + Hospitals At , New York, Ny
Identify noncompliant member for the provider to refer to on-site facility health education programs or disease management collaborative as appropriate.
2 years’ experience with medical record review working on HEDIS/QARR in a managed care or health plan setting; or
An equivalent combination of training, educational background and experience in related fields and educational disciplines.
Prior experience in Quality Improvement in a health care and/or Managed Care setting strongly preferred.
Other duties as assigned by Manager.
Knowledge of HEDIS specifications required.
Hedis Coordinator Jobs
By HCSC At , San Antonio, Tx
2 years project management experience
Knowledge of relational databases (i.e., SAS, COGNOS, SQL, and/or Oracle) experience.
4 years experience in database design, development, and reporting.
2 years experience in a health care environment.
Experience with NCQA and HEDIS reporting and/or providing technical data analysis support in a formal audit environment.
HEDIS background expereince (experience leading anual HEDIS Audit a plus)
Hedis Coordinator Jobs
By Conviva Care Solutions At , South Miami, Fl

If progressed to offer, candidates will be required to:

Are you looking for an exciting opportunity to use your expertise to review and analyze data for a leading healthcare organization? We are looking for a Hedis Reviewer III to join our team and help us ensure the quality of our healthcare services. As a Hedis Reviewer III, you will be responsible for reviewing and analyzing data to ensure accuracy and compliance with healthcare regulations. You will also be responsible for identifying areas of improvement and providing recommendations to improve the quality of our services. If you are an experienced professional with a passion for data analysis and quality assurance, this is the perfect job for you!

Overview:

HEDIS Reviewer III is responsible for performing HEDIS reviews and audits to ensure compliance with quality standards. They are responsible for analyzing data, identifying trends, and making recommendations for improvement. They must be able to work independently and collaboratively with other departments to ensure accuracy and timeliness of reviews.

Detailed Job Description:

HEDIS Reviewer III is responsible for performing HEDIS reviews and audits to ensure compliance with quality standards. They are responsible for analyzing data, identifying trends, and making recommendations for improvement. They must be able to work independently and collaboratively with other departments to ensure accuracy and timeliness of reviews. They must be able to interpret and explain HEDIS regulations and guidelines to other departments. They must be able to develop and maintain relationships with external vendors and other departments. They must be able to identify and resolve issues related to HEDIS reviews and audits.

What is Hedis Reviewer Iii Job Skills Required?

• Knowledge of HEDIS regulations and guidelines
• Ability to analyze data and identify trends
• Ability to work independently and collaboratively
• Excellent communication and interpersonal skills
• Ability to develop and maintain relationships with external vendors
• Ability to interpret and explain HEDIS regulations and guidelines
• Ability to identify and resolve issues related to HEDIS reviews and audits

What is Hedis Reviewer Iii Job Qualifications?

• Bachelor’s degree in healthcare, public health, or related field
• 5+ years of experience in HEDIS review and audit
• Certified Professional in Healthcare Quality (CPHQ) or equivalent certification
• Knowledge of healthcare quality standards and regulations
• Knowledge of data analysis and reporting

What is Hedis Reviewer Iii Job Knowledge?

• Knowledge of HEDIS regulations and guidelines
• Knowledge of healthcare quality standards and regulations
• Knowledge of data analysis and reporting

What is Hedis Reviewer Iii Job Experience?

• 5+ years of experience in HEDIS review and audit

What is Hedis Reviewer Iii Job Responsibilities?

• Perform HEDIS reviews and audits to ensure compliance with quality standards
• Analyze data, identify trends, and make recommendations for improvement
• Interpret and explain HEDIS regulations and guidelines to other departments
• Develop and maintain relationships with external vendors and other departments
• Identify and resolve issues related to HEDIS reviews and audits