Providence
Overview
Providence Health Plan is seeking a Coding Quality Auditor, HEDIS to conduct clinical quality audits and support continuous improvement within the Quality Department. The role focuses on chart extraction, data collection and audit reporting to identify opportunities for HEDIS program enhancement. Responsibilities
Conduct clinical quality audits/overreads for the Quality Department. Identify and report issues related to clinical audits to determine areas for quality improvement within the HEDIS project. Collect data by chart extraction using objective specifications for the Healthcare Effectiveness and Data Information Set (HEDIS) program. Perform chart audits electronically during the audit season. Maintain all collected records in a confidential manner. Communicate collaboratively with clinic and other staff to represent Sisters of Providence mission and philosophy. Qualifications
Technical certification/licensure in Medical Assistant, Certified Nurse Assistant or Licensed Practical Nurse upon hire. H.S. Diploma or GED. 3 years of medical record audit experience and extraction of clinical data points from medical records, experience with electronic medical records (EMR) and technology. 2 years of HEDIS, quality management/quality improvement/utilization review auditing experience, including auditing within electronic health records. Preferred Qualifications
Associate’s Degree – Nursing or Health Information Management, or related field. Experience with health plans, project management, data analysis, and/or case review. Equal Opportunity
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
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Providence Health Plan is seeking a Coding Quality Auditor, HEDIS to conduct clinical quality audits and support continuous improvement within the Quality Department. The role focuses on chart extraction, data collection and audit reporting to identify opportunities for HEDIS program enhancement. Responsibilities
Conduct clinical quality audits/overreads for the Quality Department. Identify and report issues related to clinical audits to determine areas for quality improvement within the HEDIS project. Collect data by chart extraction using objective specifications for the Healthcare Effectiveness and Data Information Set (HEDIS) program. Perform chart audits electronically during the audit season. Maintain all collected records in a confidential manner. Communicate collaboratively with clinic and other staff to represent Sisters of Providence mission and philosophy. Qualifications
Technical certification/licensure in Medical Assistant, Certified Nurse Assistant or Licensed Practical Nurse upon hire. H.S. Diploma or GED. 3 years of medical record audit experience and extraction of clinical data points from medical records, experience with electronic medical records (EMR) and technology. 2 years of HEDIS, quality management/quality improvement/utilization review auditing experience, including auditing within electronic health records. Preferred Qualifications
Associate’s Degree – Nursing or Health Information Management, or related field. Experience with health plans, project management, data analysis, and/or case review. Equal Opportunity
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
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