Hedis jobs in Hawaii

A leading healthcare recruiting firm in Kapolei is seeking a Clerk Senior to support the Quality Improvement department with medical record retrieval. This role requires at least 1 year of experience in the healthcare field and familiarity with medical terminology. The ...

 ...Description The Clerk Senior supports QI department with medical record retrieval from doctor’s offices, health clinics, and hospitals for HEDIS. Main duties: Calls provider offices. Schedules appointments for field retrievers to collect medical records Utilizes multiple... 

 ...identify trends and root causes and make recommendations based on results. Apply understanding of standard quality measures (e.g., HEDIS, CAHPS, HOS) to identify additional strategic improvement levers (e.g., supplemental data, benefits alignment) that may impact quality... 

 ...Coordinates and oversees various contractual requirements for Federal Plan 87/Postal Plan, such as the "Standard Reporting" requirements (HEDIS and NCQA requirements, Performance Standard reports, and Fraud and Abuse semiannual report). Other Responsibilities Performs all... 

 ...to ensure compliance with clinical care guidelines and documentation standards. Healthcare Effectiveness Data and Information Set (HEDIS) review is performed annually by the health plan and is managed by the QI department. HEDIS consists of a set of performance measures... 

 ...including SDLC, and AGILE preferred. • Experience with health care regulatory and clinical quality measurements frameworks such as NCQA HEDIS, Meaningful Use, PQRS, OPPE, CORE measures, etc. preferred. • Experience with QlikView or other similar visualization and analysis... 

 ...registries) while adhering to strict confidentiality standards. Compliance Reporting: Submit data for mandatory reporting, such as HEDIS measures or national quality registries, to meet accreditation standards. Quality Review: Identify, document, and correct...