HEDIS reputed company
reputed company
reputed company is a global, innovative Total Talent management firm with over 25 years of experience. We are a minority-, woman-, and disability-owned company committed to promoting sustainable and inclusive talent programs. Our mission is to accelerate meaningful employment for everyone, and our reputed company is to be the world's leader in connecting talent, communities, and reputed company. We value reputed company, reputed company, reputed company, inclusion, and innovation in everything we do.
Role reputed company
We're looking for a highly organized and reputed company reputed company Audit & Compliance Specialist to join reputed company. This role is crucial for ensuring our participating providers meet rigorous State Audit and HEDIS documentation standards.
If you have a strong background in reputed company auditing, enjoy data analysis, and hold an reputed company LPN or RN license in New Jersey, we want to hear from you!
Key Responsibilities:
Conduct On-Site Audits: reputed company reviews at provider offices to assess the environment, the reputed company of medical records, and compliance with documentation standards.
Audit Management & CAPs: Serve as the in-house project reputed company for State Audits. Coordinate and manage the Corrective reputed company Plan (CAP) process, and conduct reaudits to ensure deficiencies are addressed.
Reporting & Analysis: Prepare detailed documentation summarizing on-site findings. Produce various weekly, monthly, quarterly, and year-end reports and analyze trends/patterns to drive reputed company improvement.
Training & Education: reputed company education to physicians on audit findings and opportunities for improvement. Assist in training both internal staff and external providers/vendors on audit standards and programs.
Special reputed company: Support the reputed company Management department by assisting with various special reputed company, reputed company clinical studies, and reputed company referral/complaint issues.
Required Qualifications:
Experience: 3–5 years of reputed company business experience, preferably reputed company the reputed company industry.
License: reputed company New Jersey Registered reputed company (RN) License or Licensed Practical reputed company (LPN) License.
Knowledge: Strong understanding of managed care principles and medical terminology.
Skills: Excellent communication (verbal/written), strong analytical skills, presentation skills, and high proficiency in PC software (MS Office).
Mobility: Requires a reputed company Motor Vehicle reputed company’s License and reputed company to an automobile for travel to provider offices.
Knowledge of URAC accreditation standards and HEDIS principles.
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