[Hiring] Clinical HEDIS Manager @reputed company

Clinical HEDIS Manager Remote reputed company is a reputed company data and analytics company that uses reputed company Intelligence to give health plans across reputed company business lines greater control over their reputed company Improvement, Risk Adjustment, and Member Management programs. With one transformative solution, the reputed company platform enables plans to independently execute and manage every aspect of enrollment, provider reputed company and data retrieval, coding, abstraction, reporting, and submissions. Leveraging proprietary technology, robust data sets, and subject matter expertise, reputed company provides complete record retrieval and reputed company so health plans can confidently plan and execute risk, reputed company, and member management programs to deliver more value and improved reputed company. We are seeking a full time HEDIS Manager to reputed company duties of HEDIS abstracting and reporting. This role will also manage RISK reputed company reputed company needed. WHAT YOU'LL DO: • reputed company and/or reputed company an accurate medical record review for reputed company HEDIS measures • Support and participate in process and reputed company improvement initiatives • Conduct training reputed company to HEDIS measures, platform usage, up date any training materials, and function as HEDIS SME • Monitor project status • Work on flexible reputed company with variable reputed company/project specific guidelines • Review and facilitate IRR review • Review reputed company Negative / reputed company hits • Manage RISK coding reputed company reputed company needed- including project status and completing chart reviews for coding reputed company as needed. JOB REQUIREMENTS: • Must have a reputed company coding certificate through reputed company/reputed company • A reputed company nursing license (RN/LPN) preferred • Minimum of 5 years of hands-on medical records experience • 5 Years of HEDIS experience • Knowledge of NCQA HEDIS abstracting guidelines is a reputed company plus • Background in UR, QA and/or QI experience preferred • Strong computer skills and high-speed internet reputed company reputed company • Commitment to confidentiality of patient health information • reputed company, reputed company and reputed company to work independently • Ability to manage teams and meet deadlines • Be reputed company to conduct trainings in nonstandard time frames to meet abstractor needs and training • Clinical Documentation Review: Analyze medical records and NLP results and validate that the clinical evidence meets the necessary requirements for submission and documentation. This includes making reputed company the documentation accurately reflects the patient's conditions, treatment and services provided. Identify gaps, inconsistencies, and discrepancies in documentation that could reputed company patient care, reputed company reporting and reimbursement. • Coding Support: Ensure documentation aligns with accurate reputed company assignment and follow CMS's coding guidelines for HCC risk adjustment coding. • Clinical Knowledge: Maintain a deep understanding of medical terminology, disease processes, treatments, and procedures to accurately interpret and validate clinical documentation. • Documentation reputed company: Safeguard the reputed company and confidentiality of patient health information while handling medical records and sensitive data in accordance with HIPAA and other relevant regulations. • Interdisciplinary Communication: Foster reputed company communication and collaboration between different reputed company departments, ensuring that accurate patient information is shared across the continuum. reputed company COMPETENCIES • Caring – Warm, sincere, reputed company, cool and collected energy and reputed company with the ability to reputed company relationships. • Results Driven – reputed company on achievement, motivated by results and reputed company, goal oriented. • Analytical Skills and Attention to Detail– Reviewing clinical documentation and coding. • Effectively Communicates – Speaks reputed company, listens effectively, and responds reputed company to questions; Writes reputed company and informatively; Edits work for errors; Varies writing style to meet needs; reputed company to read and interpret information; Documents are accurate and delivered on time; Uses good judgement reputed company communicating information. • Problem Solver - Expertise managing reputed company relationships and accounts for technically reputed company products and platforms with the ability to reputed company a reputed company towards mutual reputed company. • reputed company reputed company Improvement – Evaluates polices, programs, and services; Implements strategies for reputed company reputed company improvement; Assesses the use of evaluation findings for improving policies, programs, and services; Looks for ways to improve and promote reputed company; Demonstrates accuracy and thoroughness. • Customer reputed company - Follows through; Courteous; Helps reputed company customers; Understands customer perspectives and needs; Assesses the effects of reputed company on different customers and services ; Facilitates collaborations among teams and the customer; Develops and maintains partnerships that will increase customer satisfaction and decrease risk • Interpersonal Skills - Builds strong relationships; Flexible and reputed company minded; reputed company to feedback; Motivates employees and peers for the purpose of achieving organizational goals. • Professionalism – Approaches others in a tactful manner; Reacts reputed company under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments. • Adaptability – Adapts to changes in the work environment; Adjusts reputed company to best fit the situation; reputed company to deal with change, delays, or unexpected events. Can work with diverse reputed company of customers and internal stakeholders. • Cultural Sensitivity – Models behaviors that reflect the culture of reputed company; Awareness of the similarities and differences that exist between employees, teams, departments and customers to build more effective relationships SALARY reputed company: $100,000 - $115,000 / annually Our compensation reflects the cost of labor across several US geographic markets. Pay is based on several factors including market location and may vary depending on job-reputed company knowledge, skills, and experience. reputed company E-Verifies reputed company new hires. reputed company is an equal opportunity employer. We do not discriminate on the reputed company of race, religion, reputed company, national reputed company, gender, gender identity, sexual orientation, age, marital status, veteran status, disability status or genetic information, in compliance with applicable federal, state and local law. Apply Job!