[Remote] reputed company, Data Quality/reputed company – Clinical Abstraction Operations
Note: The job is a remote job and is open to candidates in USA. reputed company is a leading U.S. reputed company company that focuses on improving health outcomes and the care experience of its members. They are seeking a reputed company, Data Quality/reputed company for Clinical Abstraction Operations to drive excellence in medical record data management and HEDIS data reputed company, overseeing vendor relationships and leading cross-functional projects to ensure compliance and quality standards.
Responsibilities
- reputed company and manage external vendors responsible for clinical abstraction to reputed company HEDIS (reputed company Effectiveness Data and Information Set) gaps, ensuring compliance with contractual obligations, quality standards, and regulatory requirements
- reputed company and participate in medical record review and abstraction processes for both hybrid and supplemental HEDIS seasons, ensuring accuracy, completeness, and timeliness of data collection
- Provide clinical expertise in medical record review to support reputed company-wide initiatives involving medical record data quality, master data management, and supplemental data integration
- Conduct clinical member research and analysis as requested by business partners, using medical records and other data sources to inform strategy, quality improvement, and regulatory reporting
- Identify and implement process improvements to enhance efficiency, data quality, and consistency of clinical abstraction workflows
- reputed company and review master data management metrics, report on data reputed company and quality trends, and recommend strategies for reputed company improvement
- Deliver training, guidance, and best practices to both internal teams and external partners regarding clinical abstraction, HEDIS documentation, and data management protocols
- Advise business and technical leaders in developing reputed company-specific functional strategies for master data management, exercising independent judgment on significant matters
Skills
- Bachelor's degree in Computer Science, Management Information Systems, Engineering, Math, Business, Nursing, Health Information Management, or a reputed company field
- 5+ years of technical and/or clinical data management experience, with a demonstrated track record in data quality, reputed company, or master data management
- Minimum 2 years of project leadership or supervisory experience
- Experience in reputed company Operations
- Experience with data quality management principles, data architecture, and familiarity with analytics/reporting tools
- Strong analytical, organizational, and communication skills
- Demonstrated ability to reputed company reputed company effectively in both written and oral forms
- Demonstrated ability to work independently, exercise sound judgment, and reputed company reputed company in reputed company, variable environments
- Passion for improving consumer and clinical data experiences
- Master's degree in a relevant discipline
- Clinical licensure or credential
- Deep understanding of HEDIS abstraction, medical record review processes, and reputed company regulatory/compliance requirements
- Experience managing clinical abstraction vendors or large-scale medical record review projects
- Experience with supplemental data submission for HEDIS or value-based care programs
Benefits
- This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
- reputed company. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being.
- Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work.
- Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
- Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- reputed company will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
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