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- Dallas, TX
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HEDIS Reviewer - Houston, TX 4108
The CSI Companies • Dallas, TX
Posted 7 days ago
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The CSI Companies is seeking a HEDIS Reviewer for a well known client in the Dallas, TX area.
Pay: Based off of experiecne
**Must be a Medical Asst, Coder, Med Rec Tech, LVN, or RN. If you are not a nurse we will require no less than 2 years of chart abstraction experience. Position will be both field and office based**
Key Duties and Responsibilities
- Collects data for ambulatory medical record reviews and compliance with provider preventive health and chronic disease outcome improvement interventions.
- Pepares reports and quality improvement studies in an accurate, concise and timely fashion.
- Conducts internal auditing for compliance with regulatory and accreditation standards, and monitors and provides consultation to departments to correct deficiencies.
- Communicates with external data sources as needed to gather data necessary to measure identified outcomes.
Provides communication such as newsletter articles, member education, outreach interventions and provider education.
- Collects and summarizes performance data and identifies opportunities for provider improvement.
- Participates in site visit preparation and execution by regulatory and accreditation agencies (State agencies, CMS, AAAHC, URAC, NCQA,EQRO).
- Pursues methods to ensure receipt of data required for trending and reporting of various QI work plan metrics.
- Assists in activities to prioritize clinical and service improvement initiatives.
- 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.
Performs other duties as assigned.
A Bachelor's Degree in a related field or equivalent work experience
3+ years of experience in HEDIS and/or quality improvement -Required
Experience in a managed care health services environment- Required
Experience in data collection and data entry- Required
Knowledge of medical terminology and/or experience with CPT and ICD-9 coding
Demonstrated interpersonal/verbal communication skills
Ability to multi-task
Ability to work in a fast paced environment with changing priorities
Ability to implement process improvements
Ability to effectively present information and respond to questions from families, members, and providers