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. Apply tot his job Apply tot his job Apply tot his job Apply To this Job