Provider Data Quality Specialist (Temp) - CMS/HEDIS
Mount Carmel West
Mount Carmel Health System is seeking a temporary full-time Provider Data Management professional in Columbus, Ohio. The role focuses on maintaining the integrity of the Health Plan's provider data, ensuring compliance with federal and local regulations. Responsibilities include conducting audits, preparing credentialing rosters, and processing data accuracy reports. Candidates should have strong communication skills and a preferred background in managed care health insurance. The position supports the Health Plan's adherence to regulatory requirements while fostering a collaborative environment. #J-18808-Ljbffr Mount Carmel Health System
- ...Full Time Position Purpose Provider Data Management role manages the integrity... ...& Medicaid Services (CMS) requirements. Additionally,... ...data as required by CMS for HEDIS purposes. The ORS-Provider Data... ...other Operations Resolution Specialists across the plan to fully resolve...Temporary workCmsHEDISRemote jobFull timeWork at officeLocal area
$72.8k - $130k
...care, pharmacy benefits, data and resources they need... ...and assist assigned provider groups and/or financial... ...revenue and expense) and quality outcomes Drive... ...directly impact revenue, HEDIS/STAR measures and quality... ...operations including HEDIS, CMS reimbursement models,...Temporary workCmsHEDISMinimum wageFull timeWork experience placementWork at officeLocal areaRemote workMonday to Friday$19 - $26 per hour
...Billing Specialist Northland - Columbus, OH 43231 Overview Salary Range $19.00... ...security policies. Collaborate with providers, clinical staff, and revenue cycle team... ...Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows...CmsHEDISHourly payFull timeLive outMonday to FridayDay shift- ...ecosystem to help improve care quality, drive better outcomes,... ...costs. Through its data-driven AI insights,... ...manner ensuring accuracy and providing customers with the... ...projects for health plan and CMS campaigns, including but not limited to: HEDIS, DRG, Risk Adjustment, Payment...CmsHEDISRemote job
- ...advanced access to high-quality, affordable, and... ...remain leaders, employers, providers, and partners of choice... ...Medicare and Medicaid (CMS), consultants, legal counsel... ...and quality metrics (HEDIS, Stars, Medicaid... ...Ability to translate complex data into actionable strategies...CmsHEDISContract workWork at officeRemote work
$87.04k - $187.46k
...accountable and prioritize safety and quality in everything we do. Join us... ..., consistent follow-up. Data fluency: uses metrics to diagnose... ...to health plans (e.g., NCQA, HEDIS-related workflows, internal... ...about available benefits are provided during the application process...Temporary workCmsHEDISHourly payFull timeWork experience placementLocal areaRemote work- Ohio Children's Alliance Provider Relations Coordinator (Healthcare Network... ...in our healthcare quality initiatives and value-based performance... ...education regarding reports, HEDIS and other quality measures;... ...regarding any provider-identified data inaccuracies or questions;...HEDISFull timeWork at officeFlexible hours
$97.9k - $133.5k
...our caring community The Data Engineer 2 will develop... ...Medicare Risk Adjustment, and quality metrics (such as HEDIS). Experience working... ...Among our benefits, Humana provides medical, dental and vision... ...nurses, behavioral health specialists and more, spend up to 50...Temporary workHEDISFull timeApprenticeshipWork at officeRemote work- ...Friday 5:30am-1:30pm Community Medical Services (CMS) is hiring a substance abuse Peer Support Specialist to assist patients recovering from addictions to... ...You will use your personal recovery experience to provide ongoing guidance, coaching, and support to individuals...Temporary workCmsMonday to FridayShift work
$65k - $100k
...Overview:The Safety Manager supports efforts to provide a safe workplace for Company employees... ...Manager mentors and supervises Safety Specialist I and II personnel in the department.... ...opportunities to collect industrial hygiene data and coordinates with third-party providers...Temporary workCmsFor subcontractorDay shift- ...on-call Saturdays 8:00am- 10:00am Community Medical Services (CMS) is hiring immediately a Nurse Practitioner or Physician... ...Services (CMS) is a CARF-accredited addiction treatment program providing services in the form of outpatient medication-assisted treatment...Temporary workCmsFull timeWork at officeImmediate startMonday to Friday
$72.7k
...assigned member panel and, using data and analytics in conjunction... ..., improves, and maintains quality outcomes (clinical, financial,... ...current knowledge and adhere to CMS, state, local, and regulatory... ...disease/condition‑management, provider operations, or health insurance...Temporary workCmsWork at officeLocal areaRemote work$142.3k - $195.7k
...integrated solutions that leverage high-quality data, data-driven insights, and technology to... ...with the Part D and PDP teams under the Provider Programs organization within Risk Adjustment... ...experience with and knowledge of the CMS Stars and/or Risk Adjustment programs....Temporary workCmsBi-weekly payFull timeApprenticeshipWork at officeRemote workWork from homeHome office$22.3 - $28.8 per hour
...series of clinical and administrative processes that healthcare providers utilize to capture, bill, and collect patient service revenue.... ...Urology and Imaging, This role supports management by ensuring high-quality coding, clean claim submission, denial prevention, and workflow...Temporary workCmsHourly payLocal areaImmediate startFlexible hours- ...subcontractors, and community./ph3What We Believe In/h3pPeople: Provide a safe, family-oriented environment. Commitment to integrity.... ...most valuable assets./ppPerformance: Always deliver the highest quality. Find solutions. Provide value to our partners./ppCommunity: Positively...Temporary workCmsContract workFor subcontractorWork at officeLocal area
- ...upholds organizational ethics, and follows CMS regulation guidelines related to... ...deliver differentiated, affordable, high‑quality, personalized health care in an accessible... ...environment. Position Summary The Supervisor provides daily oversight and direction for all public...Temporary workCmsWork at office
$34 - $41 per hour
...compliance with state and federal regulations, provider contracts, and applicable waiver... ...align with applicable administrative codes, CMS regulations, and provider agreement requirements... ...responses to incidents and support quality improvement efforts. Perform other...Temporary workCmsRemote jobContract workFlexible hours- ...the front-line team, ensuring the team is providing personalized interactions that each... ...responsibilities, organizational ethics and CMS regulations guidelines related to the complaint... ...of differentiated, affordable, high quality and personalized health care in an accessible...Temporary workCmsWork at officeShift work
- ...Mileage will be reimbursed from the clinic to the prison not from home to clinic* Community Medical Services (CMS) is hiring a Nurse to process specimens and provide outpatient medication and treatment services for those with opioid use disorder. Under the supervision of...Temporary workCmsPart timeWork at officeLocal area
- ...Columbus, OH. Paid Training Provided! You can make an... ...patient assessments, laboratory data and, when concerns are noted,... ...facilities meeting or exceeding CMS's standards in the government'... ...through clinical goal setting and quality improvement initiatives....Temporary workCmsMinimum wageShift work
$72.7k
...assigned member panel and utilizing data/analytics in conjunction with... ..., improves and maintains quality outcomes (clinical, financial... ...knowledge and adheres to applicable CMS, state, local, and regulatory... ...management experience, provider operations and / or health insurance...Temporary workCmsFor contractorsWork at officeLocal area$36 - $50.15 per hour
...greatest reward. Why Choose Arbors? One of Ohio’s Largest Providers of long-term care skilled nursing and short-term... ...professionally. Star Rating Achievement: 4-Star Rating in Quality Measures by CMS. Compensation Starting Wages at $36.00-$50.15 per hour Wage...Temporary workCmsBi-weekly payHourly payWeekly payDaily paidLocal areaFlexible hoursShift workWeekend work- ...About the job HEDIS Nurse Company Overview: Confident Staff Solutions is a leading staffing agency in the healthcare industry, specializing in providing top talent to healthcare organizations across the country. Our team is dedicated to helping healthcare...HEDIS
$298k - $409.8k
...across department(s). You will provide clinical leadership across... ...strategic initiatives that improve quality, access, and cost of care.... ...appropriateness using CMS, Medicare Advantage, and evidence... ...cross-functional environments ~ Data-driven mindset with ability to...Temporary workCmsFull timeRemote workShift work- ...dedicated to creating accurate, defensible estimates from day one, backed by our extensive historical data and self-perform trade knowledge. The Role: You'll provide estimating services for conceptual and hard bid work across diverse contract types, with a focus on...Temporary workCmsContract workFor subcontractorWork at officeFlexible hours
- ...Monday - Friday 7:00am-3:00pm Community Medical Services (CMS) is urgently hiring a Case Manager to help individuals suffering... ...maintaining progress notes and other required documentation for services provided as directed by the Clinic Manager and Clinical team members....Temporary workCmsFull timeWork experience placementWork at officeImmediate startTrial periodMonday to Friday2 days per week3 days per week
$132k - $155k
...encounters, and risk adjustment Translate Medicare regulations, CMS guidance, and industry trends into actionable product... ...consulting and implementation experience Work model We strive to provide flexibility wherever possible. Based on this role’s business requirements...Temporary workCmsFull timeWork experience placementRemote work$22.3 - $35.2 per hour
...community oncology to support patients through their journeys with cancer. As an oncology practice alliance comprised of more than 100 providers across 50 sites, Navista provides the support community practices need to fuel their growth-while maintaining their independence....Temporary workCmsHourly payWork at officeLocal areaImmediate startFlexible hours$80.5k - $103.41k
...existing applications. Responsibilities Provide Tier 2 / Tier 3 application support for DC... ...Active Warehouse Management (Active WM) CMS SYNQ / Auto Store SLAM Numina and other... ...Change and release management, Interface and data flow analysis Ability to interpret...Temporary workCmsWork experience placementLocal areaFlexible hoursShift work$165k
...seeking a highly experienced Data Architect with deep healthcare... ...clinical, claims, eligibility, provider, and social determinants of health... ..., including conducting quality assurance activities such as peer... ...support regulatory reporting (CMS, state-specific submissions, encounters...CmsRemote work
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