Pride Health is hiring Clinical Quality Analysts for our top Healthcare Insurance company! This team helps assist with the HEDIS data collection cycle
Pay: $37-$40 per hour
Shift: M-F 8 am-5 pm
Contract: December or January-May
Duties:
- Overread medical records for HEDIS measures
- Research claims systems for alternate chase opportunities/make outbound calls to providers
- Attend team meetings to provide information relating to clinical reviews
- Maintain HIPAA standards and confidentiality of protected health information
- Other duties as assigned
Requirements:
- One plus year HEDIS / medical record review
- One plus year of healthcare/ health plan industry experience
- Experience with abstraction/overread
- Experience with the following measures: BPD, CBP, CCS, COL, COA, HBD, EED, CIS, DVSCH, IMA, LSC, PPC, TRC, and WCC. Experience with LTSS, FFR, and FFS is a plus.
- RN, LPN, preferred but not required.
- Strong critical thinking skills
- Proficient in Microsoft Office (Word, Excel, Adobe, PowerPoint)
Additional Information:
- Fully remote position, M-F 8 am-5 pm in your time zone
- Ability to commit December-May
- Must complete HEDIS-specific training and testing with a passing score of 95% or higher
Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto home insurance, pet insurance, and employee discounts with preferred vendors.