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  • Dallas, TX

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HEDIS Reviewer - Houston, TX 4108

The CSI Companies • Dallas, TX

Posted 13 days ago

Job Snapshot

Experience - At least 3 year(s)
Degree - 4 Year Degree
Other Great Industries


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Job Description

The CSI Companies is seeking a HEDIS Reviewer for a well known client in the Dallas, TX area.

Pay: Based off of experiecne

**Must be a Medical Asst, Coder, Med Rec Tech, LVN, or RN. If you are not a nurse we will require no less than 2 years of chart abstraction experience. Position will be both field and office based**

Key Duties and Responsibilities 

  • Collects data for ambulatory medical record reviews and compliance with provider preventive health and chronic disease outcome improvement interventions. 
  • Pepares reports and quality improvement studies in an accurate, concise and timely fashion. 
  • Conducts internal auditing for compliance with regulatory and accreditation standards, and monitors and provides consultation to departments to correct deficiencies. 
  • Communicates with external data sources as needed to gather data necessary to measure identified outcomes. 
    Provides communication such as newsletter articles, member education, outreach interventions and provider education. 
  • Collects and summarizes performance data and identifies opportunities for provider improvement. 
  • Participates in site visit preparation and execution by regulatory and accreditation agencies (State agencies, CMS, AAAHC, URAC, NCQA,EQRO). 
  • Pursues methods to ensure receipt of data required for trending and reporting of various QI work plan metrics.
  • Assists in activities to prioritize clinical and service improvement initiatives.
  • Ensures that documentation produced and/or processed complies with state regulations and/or accrediting body requirements. 
  • Ensures assigned contract/regulatory report content is accurate and that submission adheres to deadline. 
    Performs other duties as assigned. 

    Education Level 
    A Bachelor's Degree in a related field or equivalent work experience 

    Experience Level 
    3+ years of experience in HEDIS and/or quality improvement -Required 
    Experience in a managed care health services environment- Required 
    Experience in data collection and data entry- Required 

    Skill Sets 
    Knowledge of medical terminology and/or experience with CPT and ICD-9 coding 
    Demonstrated interpersonal/verbal communication skills 
    Ability to multi-task 
    Ability to work in a fast paced environment with changing priorities 
    Ability to implement process improvements 
    Ability to effectively present information and respond to questions from families, members, and providers 

    Microsoft Excel 
    Microsoft Access 
    Microsoft PowerPoint 
    Microsoft Outlook 
How to Apply:Please send your resume in Word or PDF format to: [Click Here to Email Your Resumé]Copy and Paste the following job title and code and place it in the subject line of your email so we can identify the job: HEDIS Reviewer - Houston, TX 4108 (#158925-MH2479)
Job ID: 158925
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