About this role
Role Description
Serve as a Quality Specialist in Hedis abstraction, quality measures, audits, population health, chart reviews and gap closure.
Conduct extensive electronic medical record (EHR) review and data abstraction to validate compliance with quality metrics. EHR systems (Epic, Cerner, Athena). Ensure clinical documentation is accurate and complete to support payer audits and other contract-related requirements. Support the monitoring of performance and progress toward organizational quality measure goals. Assist in implementing system-wide workflows and interventions designed to close care gaps for preventive care, transitions, and chronic condition management.
Qualifications
High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.
Requirements
3+ years of experience in healthcare quality, population health, or a payer-side HEDIS audit/abstraction role (minimum 2 years required; 3+ preferred). Demonstrated experience with auditing/abstraction of clinical data points from medical records, with a strong focus on HEDIS measures. Google Suite (Sheets, Docs, Slides), Excel, Pivot Tables and creating presentations.
Benefits
Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community