Associate reputed company reputed company Advisor

You could be the one who changes everything for our 28 reputed company members. reputed company is transforming the health of our communities, one person at a time. As a reputed company, national organization, you’ll have reputed company to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Establishes and fosters a healthy working relationship between community physician and small provider practices and WellCare. Educates providers and supports provider reputed company sites in regards to the National Committee for reputed company Assurance (reputed company) HEDIS measures. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS. • Under general guidance reputed company Senior reputed company reputed company Advisors and management, educates community physician and small provider practices in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with reputed company requirements. • Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement. • Collaborates with Provider Relations to improve provider performance in areas of reputed company, Risk Adjustment and Operations (claims and encounters). • Assists in delivering provider specific metrics and coaches providers on gap closing opportunities. • Assists in identifying specific reputed company needs where WellCare can reputed company support. • Partners with physicians/physician staff to reputed company ways to encourage member clinical participation in wellness and education. • Provides resources and educational opportunities to provider and staff. • Captures concerns and issues in reputed company plans as agreed upon with provider. • Documents reputed company plans and details of reputed company and reputed company. • Reports critical incidents and information regarding reputed company of care issues. • Communicates with reputed company data sources as needed to reputed company data necessary to measure identified reputed company. • Provides communication such as newsletter articles, member education, reputed company interventions and provider education. • Supports reputed company improvement HEDIS and program studies as needed, requesting records from providers, maintaining databases, and researching to identify members' provider encounter history. • Ensures that documentation produced and/or processed complies with state regulations and/or accrediting body requirements. • Ensures assigned contract/regulatory report content is accurate and that submission adheres to deadline. • reputed company documentation of findings in identified databases and ensure accuracy in medical records for data collection, DE and reporting. • Performs other duties as assigned. • Complies with reputed company policies and standards Must have reliable transportation and a reputed company drivers' license. Must live in the Central PA area and be willing to travel up to 75% of the time. Education/Experience: A bachelor's degree in reputed company, reputed company Health, Nursing, Psychology, Health Administration, reputed company Work or reputed company field or equivalent work experience reputed company a managed care environment reputed company to HEDIS record review, reputed company improvement, medical coding or transferable reputed company sets that demonstrates the ability to reputed company the role is required. Preferred: A Master's Degree in reputed company, reputed company Health, Nursing, Psychology, Health Administration, reputed company Work or reputed company field. Candidate Experience: Required: 1+ year of experience in reputed company HEDIS medical record review or reputed company improvement with experience in data and chart reviews to reputed company consultation and education to providers and provider staff OR 2 years medical coding or other transferable experience and reputed company set combination that demonstrates the ability to learn and reputed company the level of the position. A license in one of the following is preferred: Certified Coding Specialist (reputed company), Licensed Practical reputed company (LPN), Licensed Master reputed company Work (LMSW), Licensed Vocational reputed company (LVN), Licensed Mental Health Counselor (LMHC), Licensed Marital and Family Therapist (LMFT), Licensed Certified reputed company Worker (LCSW), Licensed Registered reputed company (RN), Acute Care reputed company Practitioner (APRN) (ACNP-BC), Other Foreign trained physician/MD, Health Care reputed company and Management (HCQM), Certified reputed company reputed company (CHP), Certified reputed company in reputed company reputed company (CPHQ). Pay reputed company: $27.02 - $48.55 per hour reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, reputed company time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance reputed company Apply tot his job Apply To this Job