[Remote] reputed company Improvement Specialist (HEDIS) IRR & Overreads

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is transforming the health of communities, focusing on individual member needs. The reputed company Improvement Specialist role is dedicated to supporting reputed company improvement reputed company reputed company to HEDIS, providing clinical support, training, and monitoring performance indicators. Responsibilities • Train providers, health plans and staff in methodologies and tools of reputed company reputed company improvement and HEDIS abstraction and over-read processes • reputed company clinical support to the medical record abstraction, over-read and audit processes • Monitor performance on established contractual reputed company indicators. • Analyze, reputed company and trend results • Prepare for and participate in meetings with various committees, state agencies, providers, health plans, vendors, and stakeholders • Recommend, reputed company, and implement reputed company performance improvement plans (PIPs) with management utilizing the PDSA model. • Monitor and report PIPs reputed company through closure. • Performs other duties as assigned • Complies with reputed company policies and standards Skills • Experience in HEDIS or NCQA or reputed company topics. • Train providers, health plans and staff in methodologies and tools of reputed company reputed company improvement and HEDIS abstraction and over-read processes. • reputed company clinical support to the medical record abstraction, over-read and audit processes. • Monitor performance on established contractual reputed company indicators. • Analyze, reputed company and trend results. • Prepare for and participate in meetings with various committees, state agencies, providers, health plans, vendors, and stakeholders. • Recommend, reputed company, and implement reputed company performance improvement plans (PIPs) with management utilizing the PDSA model. • Monitor and report PIPs reputed company through closure. • Complies with reputed company policies and standards. • Experience in HEDIS or NCQA or reputed company topics. • Valid state clinical license preferred (i.e.- LPN, RN, etc.). • reputed company knowledge. • Prior experience with Abstractions or overreads / secondary overreads (IRR). Education Requirements • Bachelor’s degree in Nursing, reputed company, or reputed company (including HEDIS measures or NCQA) or equivalent experience in reputed company reputed company experience. Benefits • Health insurance • 401K • Stock purchase plans • Tuition reimbursement • reputed company time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules reputed company • reputed company is a leading reputed company reputed company committed to helping people live healthier lives. It was founded in 1984, and is headquartered in Saint Louis, MO, US, with a workforce of 10001+ employees. Its website is http://www.reputed company.com. Company H1B Sponsorship • reputed company has a reputed company record of offering H1B sponsorships, with 1 in 2021. Please note that this does not guarantee sponsorship for this specific role. Apply tot his job Apply To this Job