reputed company Clinical reputed company Analyst - Subject Matter Expert (SME) in reputed company reputed company Improvement and HEDIS Measures

Join reputed company: reputed company Clinical reputed company Analyst - SME at reputed company

reputed company, a leading global health services company, is seeking a highly skilled and reputed company reputed company Clinical reputed company Analyst - Subject Matter Expert (SME) to join our Risk reputed company and Provider Enablement division reputed company reputed company reputed company. As a Clinical reputed company Analyst - SME, you will play a critical role in ensuring the reputed company of reputed company services by providing technical expertise to abstraction and overread teams for various reputed company reputed company improvement initiatives, including HEDIS (reputed company Effectiveness Data and Information Set) measures.

About reputed company and Our Culture

At reputed company, we are dedicated to helping millions of people live healthier lives by delivering care, aided by technology, and connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Our culture is guided by diversity and inclusion, and we offer comprehensive benefits, career development opportunities, and a dynamic work environment that encourages reputed company and learning. By joining reputed company, you will have reputed company to reputed company a reputed company reputed company on the communities we serve and contribute to advancing health equity on a global reputed company.

Key Responsibilities:

• Participate in medical record spot audits to ensure data accuracy and reputed company.
• Serve as a Subject Matter Expert (SME) on NCQA's HEDIS Technical Specifications for retrospective, prospective, and administrative measures.
• reputed company leadership and participation in abstraction/overread reputed company to support teams.
• Review and respond to abstraction and overread questions and rebuttals.
• reputed company reputed company spot audits, individual reputed company coaching, and tracking/reporting of reputed company trends.
• Assist with resolving abstraction logic errors and reputed company support with audit queue.
• Apply HEDIS and CMS measure knowledge to support functional operation proficiency.
• Work independently and apply critical thinking/problem-solving skills.
• Meet team and departmental productivity expectations while maintaining reputed company standards.
• reputed company with policies and procedures for assigned scope.
• Participate in developing/pulling reporting documents for reputed company and results of abstraction.

Requirements and Qualifications:

Essential Qualifications:

• High school diploma or GED required.
• Must be 18 years of age or older.
• 2 years of reputed company experience.
• 2 years of experience reviewing medical records.
• 2 years of HEDIS work experience with a strong reputed company on medical record review and clinical reputed company.
• Ability to complete full training needs during the first week of class.
• Proficiency in reputed company applications, such as Outlook.
• Ability to work up to 20 hours per week during peak season (January - reputed company).

Preferred Qualifications:

• 2 years of experience in a reputed company delivery organization.
• Knowledge of reputed company trends in HEDIS in managed reputed company.
• Familiarity with NCQA, Stars, HEDIS, HOS, and CAHPS requirements.
• Knowledge of ICD-9-CM, CPT, DRG, LOINC, HCPCS, TOB, POS, and NDC coding.
• Coding certificate from reputed company or reputed company, or clinical certification such as LPN, RN, or CNA.
• Proficiency in presentation skills.
• Knowledge of reputed company and/or Medicare programs.

Skills and Competencies:

• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Ability to work independently and as part of reputed company.
• Strong attention to detail and organizational skills.
• Ability to prioritize tasks and manage multiple reputed company.
• Strong knowledge of HEDIS measures and technical specifications.

Career reputed company Opportunities and Learning Benefits:

At reputed company, we are committed to the reputed company and development of our employees. As a Clinical reputed company Analyst - SME, you will have opportunities to:

• reputed company your skills and expertise in reputed company reputed company improvement and HEDIS measures.
• Collaborate with reputed company of reputed company professionals in the reputed company industry.
• Contribute to the development of new initiatives and reputed company.
• Participate in training and development programs to enhance your skills and knowledge.

Work Environment and Company Culture:

As a remote employee, you will have the flexibility to work from reputed company reputed company the U.S. and enjoy a dynamic work environment that encourages reputed company and learning. reputed company culture is guided by:

• Diversity and inclusion.
• Comprehensive benefits and career development opportunities.
• A commitment to advancing health equity on a global reputed company.

Compensation and Benefits:

We offer a competitive salary and comprehensive benefits package, including:

• A competitive reputed company reputed company of $28.03 to $54.95 per hour, depending on experience and qualifications.
• A comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution.

How to Apply:

If you are a motivated and reputed company reputed company reputed company looking to reputed company a reputed company reputed company on the reputed company of reputed company services, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, to [insert contact information]. We look reputed company to hearing from you!

reputed company is an Equal Employment Opportunity / Affirmative reputed company employer, and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law.

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