Average salary: $67,398 /yearly
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- ...provider in Southfield, Michigan is seeking a Quality Specialist. The role requires strong data analysis skills and experience with HEDIS and Gaps in Care measures. Responsibilities include monitoring quality standards for patient care, collaborating with vendors, and providing...HEDIS
- ...provider educational sessions in person and virtually on relevant topics such as new business tools, billing/coding, Health e-Blue (HeB), HEDIS, medical record reviews, etc. Perform clinical reviews with knowledge of clinical documentation, body systems, anatomy and...HEDISLocal area
ICONMA
New Hudson, MI5 days ago - ...an individual to establish relationships between community physicians and provider practices. Responsibilities include educating on HEDIS measures and analyzing provider performance. Candidates should have a Bachelor's degree in a related field, with 1+ years in HEDIS medical...HEDISHourly pay
- ...seeking an Associate Quality Practice Advisor based in Wayne, Michigan. This full-time remote role involves educating providers on HEDIS measures, analyzing performance data for quality improvements, and supporting healthcare compliance initiatives. Candidates must possess...HEDISRemote jobFull time
- ...education to staff as appropriate Actively participates in ongoing meetings pertaining to patient care and clinical excellence Implements HEDIS measure campaigns and other quality initiatives to ensure the highest standards of care and to promote the improvement of care...HEDISLocal areaMonday to Friday
- ...acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more We are currently recruiting RNs, LPNs, MA's, Certified Coders, and RHIT...HEDISPermanent employmentFull timeLive inWork from home
Altegra Health
Grand Rapids, MI5 days ago $600 - $720 per day
...What you’ll do Conduct Comprehensive Health Assessments via telehealth Complete risk adjustment documentation (HCC coding) Close HEDIS care gaps during patient visits Document visits using ICD-10 and CPT II codes Review patient history, medications, and preventive...HEDISDaily paidFor contractorsRemote workFlexible hours$14.3 - $20.42 per hour
...appointments, when necessary. Escorts patients to exam rooms and ensures their comfort and well-being prior to leaving. Acts as HEDIS champion for the PCP by providing visibility of HEDIS needs for scheduled patients. Reports on hospitalizations including HITS...HEDISHourly payFull timeWork experience placementWork at officeImmediate startChenMed
Warren, MI5 days ago$47.05 per hour
...machine learning solutions within production environments at scale. Apply appropriate machine learning techniques that directly impact HEDIS/Stars initiatives Data Collection and Optimization: Collect and analyze data from a variety of SQL environments (Snowflake, SQL...HEDISWork experience placementImmediate startBaylor Scott & White Health
Lansing, MI1 day ago$54.36k - $77.66k
...analytics and dashboards to assist with the development and execution of business strategies that increase revenue and quality ratings (HEDIS/STARS/Clinical Gaps) and support our core model. Develops protocols and procedures to improve staff productivity. Collaborates...HEDISHourly payFull timeWork experience placementWork at officeFlexible hoursShift workChenMed
Detroit, MI3 days ago$80.17k - $129.59k
...including CMS and Medicaid requirements. Familiarity with clinical, quality, or risk adjustment program workflows. Understanding of HEDIS, CAHPS, STAR Ratings, and quality benchmarking methodologies. Ability to interpret healthcare data and translate insights into...HEDISRemote jobWork experience placement- ...Condition Categories (HCC) model within 30 days of hire Demonstrates understanding and working knowledge of key elements of Quality STAR/HEDIS measures within 30 days of hire Rotation of telephonic on call coverage after hours Qualifications and Skills Current and valid...HEDISFull timeReliefMonday to FridayFlexible hoursShift work
$170k
...exceed a rigorous set of high-value care model process (i.e. fidelity to core model activities) and value outcomes (e.g: utilization, HEDIS metrics), individual engagement and activation goals, and financial targets (e.g: medical cost, revenue, membership growth). Provide...HEDISFull timeLocal areaFlexible hours- ...including requesting medical records, service reminders to ensure members and providers are completing tests and screenings impacting Hedis/Star measures. Assist in monitoring work plans and process flows to ensure completion on tasks associated with various projects....HEDISWork at officeShift work
- ...as needed. Provides and process records in accordance with HIPPA and PHI (Protected Health Information) disclosures. May comply with HEDIS audit information process requests as needed. Other Functions Performs other duties as assigned During a public health emergency,...HEDISTemporary workWork at office
- ...flexible, self‑motivated, detail oriented, and a constant learner. As a Quality Specialist, you will be the subject matter expert for HEDIS/Gaps in Care measures. You will ensure maintenance of programs for patients in accordance with prescribed quality standards; conduct...HEDISBi-weekly payTemporary workWork at officeFlexible hours
$27.02 - $48.55 per hour
...support needed to close care gaps and maintain continuity of care. Collaborate with providers to share quality performance data (e.g., HEDIS, CAHPS) and support improvement initiatives. Educate members on preventive care, chronic condition management, and available...HEDISHourly payFull timePart timeSeasonal workH1bWork at officeLocal areaRemote workWork from homeFlexible hours- ...methodology, practice, and implementation. Knowledge of Quality Management and Quality Improvement principles and practices. Knowledge of HEDIS measures and standards. Supervisory skills. Management skills. Leadership skills. Administration skills Training skills....HEDISWork at officeLocal area
- ...teams, as applicable ensuring consistent communication of goals, progress, and risks for program measures and categories including HEDIS/HOS, CAHPS, Pharmacy, and Plan Operations/Member Experience. Establish clear roles, responsibilities, and escalation paths to streamline...HEDISContract workFor contractorsShift work
- ...improvement projects. Under the direction of the Director of Quality and Compliance, monitors utilization and service quality through HEDIS quality measures, payer/provider agreements, patient satisfaction surveys and complaints. Facilitate strategic relationships with...HEDISFull timeTemporary workWork at officeFlexible hours
$27.02 - $48.55 per hour
...WellCare. Educates providers and supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving...HEDISHourly payFull timeContract workPart timeWork experience placementWork at officeRemote workFlexible hours- ...projections and goals. Promotes quality of care for DWIHN members. Monitors compliance with quality metrics including but not limited to HEDIS measures and other quality indicators. Participates in Root Cause Analysis and special Quality Assurance reviews. Provides...HEDISFull timeTraineeshipLocal areaWeekend work
$94.9k - $130.5k
...leading cross-functional discussions Preferred Qualifications Master's Degree Knowledge of claims processes Knowledge of Stars and HEDIS Knowledge of clinical quality benchmarks and reporting requirements for value base providers Certification with Six Sigma and/or...HEDISFull timeContract workTemporary workFor contractorsApprenticeshipWork at officeRemote workWork from homeHome office$19 per hour
...REQUIREMENTS: Conduct patient outreach and provide education on preventive screenings and chronic disease management. Address HEDIS care gaps and engage high emergency department utilizers to connect with their PCP. Perform Social Determinants of Health (SDOH)...HEDISHourly payFull timePart timeWork at officeSoutheastern Michigan Health Association
Wayne, MI29 days ago$19.28 per hour
...individual health plans, quality care frameworks, and associated measures (e.g. healthcare effectiveness data and information set (HEDIS). - Monitors quality metrics, category changes, volume/census date, and reporting requirements to ensure compliance and effective...HEDISHourly payWork experience placement- ...- Follow rooming procedure including asking about recent ER/Hospital visits, taking vital signs, reviewing medication list and due HEDIS or UDS measures, completing screening tests and health maintenance orders as identified in the chart preparation. Record in the EHR...HEDISFull timeTemporary work
- ...’ll Do Review patient documents and accurately assign CPT, CPT Category II, ICD-10-CM codes, and quality reporting measures like HEDIS. Verify records for billing, reimbursement, and regulatory compliance, while effectively communicating with providers to ensure accurate...HEDISFull timeRemote workRelocation packageMonday to Friday
- ...collaborate operational and regional leadership to deliver on our Value Based Care model. Leading a team and managing KPI outcomes and HEDIS measures for the group, you have 1/2 of the week dedicated to these outcomes, collaborative and chart review time, the remainder of...HEDISFull timeWork at officeMonday to FridayAfternoon shift
- ...determine clinical appropriateness for acute care authorizations. Support strategies to comply with state, federal, CARF, NCQA, and HEDIS regulations/initiatives. Provide support to community partners and network staff related to acute services and best practices....HEDISWork at officeAll shifts
- ...clinical/placement concerns, and treatment/discharge options. Support strategies to comply with state, federal, CARF, NCQA, and HEDIS regulations/initiatives. Provide/support training to community partners and network staff related to acute/crisis services and...HEDISContract workTemporary workWork at officeLocal areaRemote work
