Average salary: $73,839 /yearly
More statsSearch Results: 45 vacancies
...Position: HEDIS Quality Reviewer/ Clinical Quality Reviewer
Duration: 03+ months contract (Possible extension)
Location: Manhattan, NY 10004
Shift :: 9:00am- 5:00pm (Hybrid)
Job Description:
The primary function of the Clinical Quality Reviewer...
HEDIS
Contract work
Temporary work
Shift work
...Enter Job Description...
Maintain knowledge of medical record review and EMR systems.
Maintain up-to-date knowledge of HEDIS, QARR and Star specifications
Distribute requests for records and schedules appointments with provider offices to ensure timely completion...
HEDIS
$85k - $106.3k
...requirement.
Conducts clinical reviews with primary care providers or specialist to address non-adherence and/or clinical diagnosis for HEDIS/QARR exclusion.
Participates and leads improvement teams and projects and other committees related to performance improvement,...
HEDIS
Holiday work
Full time
Flexible hours
...and to educate patients.
Engage and participate in departmental meetings and PI initiatives.
Assist and conduct outreach with HEDIS/QARR measures.
Demonstrate professionalism when interacting with all support staff, clinical staff, managers, department heads and...
HEDIS
Full time
Local area
Shift work
Afternoon shift
..., including education on the planning and preparation of food at home for these patients.
Performs patient outreach to help meet HEDIS measures. Coordinates with supporting departments (i.e. referral) on nutrition services covered by insurance and performs patient outreach...
HEDIS
Holiday work
Contract work
Local area
Night shift
Weekend work
Afternoon shift
...and other materials.
Sterilize instruments and maintain clinic and clinic equipment in a hygienic condition.
Meet metrics for HEDIS measure dental annual visit and dental screenings
Qualifications:
Four-year High School diploma or its educational equivalent...
HEDIS
Temporary work
...providing orientation and mentoring for new providers
MEASURES OF SUCCESS:
1. Clinical performance improvement measures - ie QARR, HEDIS, MSHP Monthly Sites Report, Other MMG Smart Reports that include School Health Program services, for their own practices and for the...
HEDIS
Permanent employment
Full time
Part time
Shift work
...York State Medicaid and CMS Medicare regulations and related reporting requirements such as STARS, QARR, MMCOR, MEDS, RAPS, EDGE and HEDIS required
~ Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population...
HEDIS
...reports to the CMO for Gotham Health and works with the Gotham Health quality and safety team to ensure top performance as measured by HEDIS, CMS, HRSA, Article 28 and other regulatory agencies.
Responsibilities:
~ Oversee and drive the culture of quality and safety...
HEDIS
...an electronic health record preferred. (eClinicalWorks strongly preferred); Knowledge of medical terminology required; Knowledge of HEDIS/QUARR and/or UDS Measures preferred; Proficiency in MS Office, including Word, Excel, PowerPoint required; Excellent verbal and written...
HEDIS
Work experience placement
$58.3 - $77.72 per hour
...of practice, preferred
Clinical home care experience or two years managerial experience, preferred
Demonstrated knowledge of Hedis and QARR quality measures, ICD-10 and CPT coding for reimbursement of services, required
Bilingual skills, as determined by operational...
HEDIS
Hourly pay
Full time
Immediate start
Remote job
...processes.
Synthesize data that aggregates quality projects outcomes (chart reviews, incident reports, gaps-in-care, quality scorecards, HEDIS measures, etc.) for the Health Home membership.
Supports implementation and update of Federal, State, local, and payer policy/...
HEDIS
Local area
...as following up by phone on lab results and hospital discharges.
Assist with gathering information to comply with star measures, HEDIS, and all other guidelines.
EDUCATION, TRAINING, EXPERIENCE:
High school graduate of equivalent.
Graduate from an accredited Medical...
HEDIS
Permanent employment
Flexible hours
...health and performance improvement metrics, synthesizing and analyzing payer claims data feeds to monitor quality performance such as HEDIS metrics. The Senior Data Analyst should be familiar with external benchmark sources (i.e., Medicare fee schedules, Milliman data,...
HEDIS
Contract work
Local area
...training as per department directives.
* Implements clinically focused member assessment and health coaching - activities to address HEDIS quality measures.
* Conducts member transitions of care medication reconciliation to improve clinical outcomes.
* Performs, as...
HEDIS
Full time
...regulatory requirements and associated product and/or operational workflows within the domain of pharmacy benefits
~ Knowledge of HEDIS and Risk-Adjustment/RxHCC methodologies
~ Familiarity with state pharmacy encounter and healthcare exchange submissions
Base...
HEDIS
Contract work
Local area
Remote job
Flexible hours
Shift work
...department works closely with other clinical teams to help the organization achieve top quality performance on key indicators like HEDIS, QARR, and Medicare Advantage Star ratings. The Manager of Population Health Strategy leads organizational efforts to improve Healthfirst...
HEDIS
Temporary work
Work experience placement
Local area
...integrating HL7-compliant data (e.g., C-CDA or FHIR), including insurance claims, enrollment, electronic health records, risk adjustment, or HEDIS quality.
COMPENSATION: $185,000 plus equity
BENEFITS
~ Medical / Dental / Vision insurance
~ Flexible Spending Account...
HEDIS
Remote job
Flexible hours
..., secure health messages and/or patient portal). This includes collaboration with Downstate Managed Care office to improve NY QUARR/HEDIS/Press Ganey scores and use of patient registries, online managed care portals, or other data tools.
* Provide Tracking and follow-...
HEDIS
Full time
Monday to Friday
...out monthly schedule in order to meet monthly productivity expectations
* Possess knowledge of health risk evaluations including HEDIS, stars, and risk-adjustment
Preferred Requirements:
Prior knowledge or experience with oversight of 1099 contractors
Previous...
HEDIS
Holiday work
For contractors
Immediate start
Remote job
Night shift
Afternoon shift
