HEDIS Reviewer II job in Los Angeles, CA
Vacancy has expired
Los Angeles, CA CorTech LLC
| Job Ref: | 350887 |
| Employer: |
CorTech LLC |
| Job Type: | Contract |
| Salary and Benefits: | 30.62/Per Hour |
| Remote: | No |
Location |
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| City: | Los Angeles, CA |
| Post Code: | 90048 |
| Map: |
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Description |
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JobsRUs.com. is seeking to hire a HEDIS Reviewer II for our client in Los Angeles, CA! Benefits Available! Weekly Pay! $30.62/Hour Days & Hours Monday - Friday 8am-5pm Position Summary Participates in the review of medical records to abstract clinical information for HEDIS reporting. May require travel to physician offices; Nursing license preferred but not required. Successful HEDIS review experience may be substituted for licensure. Duties Interprets relevant clinical criteria and/or medical policy/benefits for an identified case. Determines when to consult appropriate provider or practitioner and to review case with medical Director for additional action. Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements. Prepares and reports business information to internal and external constituents. Consults with the constituents on solutions to business issues. Identifies trends involving clinical issues and reports/recommends solutions to senior management and others. Conducts audits and/or assessments to determine compliance with guidelines. Identifies gaps and May assist in the development/re-evaluation of corrective action plans. Experience 2-4 years audit or related business experience required. 2 years Clinical Experience Required Preferred Managed Care experience preferred. | |
ref: (350887)
832 days ago
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