HEDIS Quality Specialist
7 days ago
ALTA IT Services, LLC is seeking a skilled HEDIS Quality Specialist to support a leading health insurance customer. The ideal candidate will have extensive knowledge of HEDIS measures and medical record review processes.
Key Responsibilities:- Retrieve medical records via EMR or fax request, ensuring compliance with HIPAA and member confidentiality requirements.
- Conduct thorough medical record reviews using proprietary tools and software.
- Abstract medical records for gap closure and additional data gathering.
- Utilize expertise in HEDIS and Quality Measures to meet productivity and quality targets.
- Ensure compliance with NCQA guidelines and technical specifications.
- At least two consecutive HEDIS seasons.
- Two years clinical experience and good understanding of medical terminology.
- Strong interpersonal skills and ability to work independently.
- Current knowledge of clinical practices and related medical policies.
- Experience in using Microsoft Office and web-based technology.
Benefits: Competitive hourly rate of $29, 90% remote work arrangement, and one week of training onsite.
Qualifications: LPN or Certified Medical Assistant required.
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HEDIS Quality Specialist
1 week ago
Baltimore, Maryland, United States Collabera Full timeJob Title: HEDIS Quality SpecialistWe are seeking a skilled HEDIS Quality Specialist to join our Quality Team. As a key member of our team, you will be responsible for ensuring accurate data collection and compliance with HIPAA standards.Key Responsibilities:Retrieve and document medical records, adhering to HIPAA guidelines.Conduct medical record...
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Clinical HEDIS Specialist
3 weeks ago
Baltimore, Maryland, United States Collabera Full timeJob Summary:We are seeking a skilled Clinical HEDIS Specialist to join our team at Collabera. As a key member of our healthcare quality team, you will be responsible for abstracting and reviewing medical records to ensure compliance with HEDIS standards.Key Responsibilities:• Abstract and review medical records to identify quality metrics and trends•...
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Hedis Specialist
3 weeks ago
Baltimore, Maryland, United States Zolon Tech Solutions, Inc. Full timeJob Title: Hedis**Job Summary:**We are seeking a skilled Hedis professional to join our team at Zolon Tech Solutions, Inc. in Baltimore, MD. The ideal candidate will have experience in conducting thorough HEDIS overreads and working in a remote environment.**Key Responsibilities:**• Conduct HEDIS overreads in line with industry standards• Work closely...
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Hedis Abstractor
3 weeks ago
Baltimore, Maryland, United States Zolon Tech Solutions, Inc. Full timeJob Title: Hedis Abstractor Job Summary: We are seeking a skilled Hedis Abstractor to join our team at Zolon Tech Solutions, Inc. Key Responsibilities: * Conduct thorough Hedis overreads in line with NCQA guidelines * Assist with Medical Record Retrieval for Hedis and Risk Adjustment * Participate in internal audits for Supplemental Data * Support other...
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HEDIS Medical Review Nurse Specialist
3 weeks ago
Baltimore, Maryland, United States nTech Workforce Full timeJob SummarynTech Workforce is seeking a skilled HEDIS Medical Review Nurse to join our Quality Team. As a key member of our team, you will be responsible for conducting thorough HEDIS overreads in accordance with NCQA guidelines.Key ResponsibilitiesAssist with Medical Record Retrieval for HEDIS and Risk AdjustmentParticipate in internal audits for...
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Clinical Quality Specialist
2 days ago
Baltimore, Maryland, United States TEKsystems Full timeJob Title: Clinical Quality SpecialistWe are seeking a highly skilled Clinical Quality Specialist to join our team at TEKsystems. As a Clinical Quality Specialist, you will play a critical role in ensuring the quality and accuracy of medical records and data.Key Responsibilities:Retrieve medical records via EMR or fax request, ensuring compliance with HIPAA...
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Certified Medical Assistant
4 days ago
Baltimore, Maryland, United States Charter Global Full timeJob Title: Quality AssuranceLocation: Baltimore, MD (Hybrid)Duration: 9+ Months ContractQualificationsEducation Level: Bachelor's degree in Nursing, Associates Degree in Nursing, Diploma in NursingExperience: 5 years of recent HEDIS abstractions / overreads experience in the payer/health insurance side of HEDIS or with a HEDIS vendor (ex. Cotiviti, Inovalon,...
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Clinical Healthcare Specialist
3 weeks ago
Baltimore, Maryland, United States Charter Global Full timeJob Title: Registered NurseJob Summary:We are seeking a highly skilled Registered Nurse to join our team at Charter Global. As a Registered Nurse, you will be responsible for providing high-quality patient care and contributing to the development of our healthcare services.Key Responsibilities:Provide clinical expertise in patient care and treatment...
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Clinical Medical Review Nurse Specialist
3 weeks ago
Baltimore, Maryland, United States Zolon Tech Inc. Full timeJob Title: Clinical Medical Review NurseJob Summary:Zolon Tech Inc. is seeking a skilled Clinical Medical Review Nurse to join our Quality Team. As a key member of our team, you will be responsible for conducting thorough HEDIS overreads in line with NCQA guidelines.Key Responsibilities:Conduct HEDIS overreads in line with NCQA guidelinesHelp with Medical...
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Clinical Medical Review Nurse Specialist
1 week ago
Baltimore, Maryland, United States Three Point Solutions Full timeJob OpportunityPosition: Clinical Medical Review NurseDuration: 6 Months ContractClient: Medical Device Manufacturing CompanyLocation: Baltimore MD 21224Job Summary:The Clinical Medical Review Nurse will report to the Clinical Support Supervisor HEDIS and work as part of the Quality Team. Responsibilities include conducting HEDIS overreads per NCQA...
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Clinical Pharmacist
2 weeks ago
Baltimore, Maryland, United States CareFirst BlueCross BlueShield Full timeJob SummaryCareFirst BlueCross BlueShield is seeking a highly skilled Quality Clinical Pharmacist to join our team. As a key member of our organization, you will play a critical role in improving and maintaining the quality of care provided to our members.Key ResponsibilitiesDevelop and implement strategies to improve Star and HEDIS ratings, focusing on...
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Clinical Nursing Specialist
3 weeks ago
Baltimore, Maryland, United States Collabera Full timeJob DescriptionCollabera is seeking a highly skilled Nurse Assistant to join our team.Key Responsibilities:Provide high-quality patient care and support to patients with various medical conditions.Collaborate with healthcare professionals to develop and implement effective care plans.Conduct thorough assessments and document patient information...
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Clinical Medical Review Nurse Specialist
2 weeks ago
Baltimore, Maryland, United States Three Point Solutions Full timeJob OverviewThe Clinical Medical Review Nurse will play a crucial role in ensuring the quality and accuracy of medical records. This position requires a strong clinical background and excellent analytical skills to review and correct medical abstracts.Key Responsibilities:Conduct thorough reviews of medical records to ensure accuracy and...
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Clinical Medical Review Nurse
3 weeks ago
Baltimore, Maryland, United States Charter Global Full timeJob Title: Registered Nurse - HEDISJob Summary:We are seeking a highly skilled Registered Nurse with experience in HEDIS overreads to join our Quality Team at Charter Global. As a Clinical Medical Review Nurse, you will play a critical role in ensuring the accuracy and quality of our HEDIS data.Key Responsibilities:Conduct thorough HEDIS overreads in line...
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Clinical Medical Review Nurse Specialist
3 weeks ago
Baltimore, Maryland, United States Ampcus Full timeJob Title:Clinical Medical Review NurseJob Summary:Ampcus Inc. is a leading provider of technology and business consulting services. We are seeking a highly skilled Clinical Medical Review Nurse to join our team.Key Responsibilities:Accurately and efficiently over-read medical record abstractions performed by the HEDIS abstraction staff on a daily basis...
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Clinical Medical Review Nurse Specialist
1 week ago
Baltimore, Maryland, United States Ampcus Full timeJob Title:Clinical Medical Review NurseJob Summary:Ampcus Inc. is a leading provider of technology and business consulting services. We are seeking a highly skilled Clinical Medical Review Nurse to join our team.Key Responsibilities:Accurately and efficiently over-read medical record abstractions performed by the HEDIS abstraction staff on a daily...
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Clinical Medical Review Nurse Specialist
7 days ago
Baltimore, Maryland, United States Ampcus Full timeJob Title:Clinical Medical Review NurseJob Summary:Ampcus Inc. is a leading provider of technology and business consulting services. We are seeking a highly skilled Clinical Medical Review Nurse to join our team.Key Responsibilities:Accurately and efficiently over-read medical record abstractions performed by the HEDIS abstraction staff on a daily...
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Clinical Medical Review Nurse
2 weeks ago
Baltimore, Maryland, United States Ageatia Global Solutions Full timeClinical Medical Review Nurse Job DescriptionWe are seeking a highly skilled Clinical Medical Review Nurse to join our team at Ageatia Global Solutions. As a key member of our Quality Team, you will play a critical role in ensuring the accuracy and quality of our HEDIS data.Key Responsibilities:Conduct thorough HEDIS overreads in line with NCQA...
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Clinical Medical Review Nurse
2 weeks ago
Baltimore, Maryland, United States Charter Global Full timeJob Title: Clinical Medical Review NurseJob Summary:We are seeking a highly skilled Clinical Medical Review Nurse to join our Quality Team. The successful candidate will be responsible for conducting thorough HEDIS overreads, medical record retrieval, and abstraction, as well as participating in internal audits and supporting other needs within the Quality...
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Clinical Medical Review Nurse
3 weeks ago
Baltimore, Maryland, United States Collabera Full timeAbout the RoleThe Clinical Medical Review Nurse will be responsible for conducting thorough HEDIS overreads in accordance with NCQA guidelines.This role will report to the Clinical Support Supervisor - HEDIS and will be an integral part of the Quality Team.ResponsibilitiesAccurately and efficiently over-read medical record abstractions performed by the HEDIS...