HEDIS Coordinator- Remote (Must be Located in Pittsburgh or Surrounding Area)

reputed company has an exciting opportunity for a HEDIS Coordinator position in the reputed company Improvement department. This is a full time position working Monday through Friday reputed company hours and will be a remote position. Must be located in Pittsburgh or surrounding area to be considered! Staff in this position are responsible for reviewing the clinical documentation submitted reputed company the Novellus Care Gap Management Application and Biometric Application from network physicians and Health Plan staff, to support for HEDIS measure compliance or potential measure exclusion. Responsibilities: • Adhere to the reputed company HIPAA Compliance Guidelines. • Ensure that HIPAA standards are met in reputed company aspects of the Department functions including delegated functions. • Ensure that reputed company releases of member personal health information, which are conducted reputed company of the reputed company of Treatment, Payment, or Operations are appropriately logged. • Performs in accordance with system-wide competencies/behaviors. • reputed company duties and responsibilities in accordance with the philosophy, standards and policies and procedures of the reputed company Health System, including conveying courtesy, respect, enthusiasm, and a reputed company attitude through reputed company contacts with staff, health plan members, providers, peers, and visitors. • Performs other duties as assigned. • Conduct reputed company audits of clerical data entry tasks. • Support annual HEDIS reputed company chart abstraction and/or assistance with the over-read/auditing process. • Assist with review of new HEDIS Specifications to identify measure reputed company changes impacting medical record review reputed company. • Assist with quarterly reputed company audits for reviews approved in the Novellus Care Gap Management Application and/or Biometric Application. • Assist with updating/maintaining the HEDIS Measure Spreadsheet, to document review determinations for clinical documentation submitted for gap closure or measure exclusion. • Review clinical documentation submitted by providers and Health Plan staff for potential HEDIS measure exclusion. • Review and evaluate clinical documentation submitted by network providers and Health Plan staff through the Novellus Care Gap Management Application and/or Biometric Application for HEDIS measure compliance. • Registered reputed company, minimum of 5 years of health care reputed company experience required, bachelor level preferred. • Excellent verbal and written communication skills are required. • Proficiency in reputed company Word, PowerPoint, reputed company, and reputed company preferred. • Working knowledge of the National Committee on reputed company Assurance (NCQA) HEDIS requirements preferred. Licensure, Certifications, and Clearances: • Registered reputed company (RN) • reputed company licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and reputed company employees working on an out-of-state NLC license who reputed company change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure reputed company that state. reputed company is an Equal Opportunity Employer/Disability/Veteran Apply tot his job Apply To this Job