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Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. 3+ years of experience in HEDIS record collection and risk adjustment (coding.
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Delivers, advises and educates provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with state, federal, and NCQA requirements.
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Acts as a resource for the health plan peers on HEDIS measures, appropriate medical record documentation and appropriate coding. Maintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards.
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The organization exceeds the 90th percentile in most HEDIS measures, is among the top provider groups nationally in patient experience and provides care at a cost well below market competitors.
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Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS and documentation standards.
$25.97 - $46.68 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Provide educational support to physicians and staff to ensure process improvement and increase member satisfaction, member retention, continuity of care and drive HEDIS and QARR improvement activities.
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At least 3 years of experience in population health, quality, HEDIS, chronic care management, or a similar environment. This position will serve as a member of the Value-Based Care (VBC) team at Alo Solutions.
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Current HIM or Coding Certification (AAPC, AHMIA or another national agency) Working Knowledge of PCMH and HEDIS reporting; and proficiency in the use of Window Based PC system and a range of software packages, including Microsoft Outlook.
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Job Description About the Role: We are seeking a highly motivated and detail-oriented Clinical Pharmacist with a PharmD degree and experience in HEDIS medication adherence initiatives. Active pharmacist license in GA. Minimum of 2 years of experience in HEDIS-related medication adherence work, quality improvement, or population health.
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To assist with coordination of health maintenance screenings/assessments directly related CMS/HEDIS quality measures and medication adherence measures by referral to EHC specialists, other EHC healthcare facilities and RN Ambulatory Care Coordinators as needed to improve or maintain overall patient health.
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The Associate Medical Director will support the CMO for medical dental, pharmaceutical, and or social initiatives and quality programs as required to achieve the appropriate utilization, affordability, HEDIS and Star goals of the C&S Health Plan. The Associated Medical Director is accountable for building and leaning into relationships with internal and external partners to meet or exceed market requirements.
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Familiar with HRSA, HEDIS, Government HealthCare practices, and general Population Health Analytics. Knowledge of clinical quality measures and clinical decision support systems.
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Apply knowledge of the broad principles of health and clinical informatics, clinical systems, and healthcare processes at the point of care to enable decision-making and support for CCI.
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This position requires the coder to be highly proficient in the proper assignment of ICD-10 CM, PCS, CPT, HCPCS, HCC, HEDIS CAT II, E/M and modifier codes. Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care.
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Adheres to all Corporate and Departmental policies and ensures all regulatory requirements such as DOH, CMS, Medicaid, and accreditation requirements such as NCQA, URAC and HEDIS functionalities are met or exceeded.
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hedis job Title: decision support analyst Company: Highmark Health
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