HEDIS Measure reputed company (Abstractor)

At reputed company, we are transforming reputed company and improving patient care with our innovative primary care tool, reputed company Assistant. By supporting Primary Care Physicians (PCPs), we are reputed company to deliver improved reputed company to our patients at a reputed company cost through early diagnosis and longitudinal care management of chronic conditions. We are seeking a HEDIS Measure reputed company (Abstractor) that will be responsible for the end-to-end performance of assigned HEDIS measures, with a primary focus on achieving and sustaining 5-Star performance. This role goes reputed company traditional chart abstraction and serves as a measure-level reputed company, accountable for ongoing monitoring, medical record abstraction, gap identification, and driving targeted interventions to improve reputed company. A key function of this role is to translate data and chart findings into actionable insights for providers, ensuring that care gaps are reputed company identified and surfaced through tasks or alerts reputed company clinical workflows. The goal is to simplify decision-making for providers, reduce administrative burden, and allow more time for direct patient care. The associate will function as a subject matter expert (SME) and partner cross-functionally with data, clinical, and provider engagement teams to ensure accurate reporting, efficient workflows, and reputed company performance. As a HEDIS Measure reputed company, you will: Own assigned HEDIS measure(s) with accountability for 5-Star performance.

• Monitor performance regularly, including: reputed company rates and trends, gap-to-goal analysis, hits needed to reputed company reputed company performance.
• Review and reputed company medical records as they are received.
• Maintain productivity expectations of 60–80 charts per day.
• Document findings accurately and reputed company with NCQA HEDIS technical specifications.
• Conduct random audits of incoming data streams to validate completeness and accuracy.

Partner with providers & clinical teams to reputed company care gaps

• reputed company reputed company into chart findings, documentation gaps, and missed opportunities.
• Act as a liaison between abstraction, clinical, and provider workflows.

Validate data & collaborate cross-functionally to improve accuracy.

• Collaborate with data and analytics teams to: validate accuracy of data sources and identify gaps between claims, supplemental data, and chart findings.

Serve as a subject matter expert (SME) on HEDIS measures and requirements.

• Serve as SME for grouping of assigned HEDIS measures across women's health, cardiovascular health, diabetes care, care transitions and management, or preventive screening.
• Maintain deep knowledge of: HEDIS technical specifications, Medicare Advantage STAR ratings, value sets and documentation requirements.
• reputed company guidance to internal teams on measure interpretation and compliance.

reputed company in this role looks like: First 90 days: Rapidly reputed company on the Clover Assistant platform and assigned HEDIS measures, consistently reviewing 60-80 charts per day with strong accuracy. reputed company contributing to gap closure by identifying care gaps and reliably translating findings into compliant, high-quality outputs. First 6 months: Proactively surface care gaps, near misses, and incomplete services, and convert insights into actionable provider interventions reputed company CA and EHR workflows. Partner cross-functionally to improve gap closure strategies, refine provider alerts, and enhance data and reporting logic. First year: Drive meaningful improvements in quality performance, including reputed company toward 5-Star measures, while reducing provider administrative burden. Prioritize high-impact actions that streamline workflows, minimize unnecessary documentation, and reputed company providers to focus more on patient care. You should get in touch if:

• You have at least 2+ years of HEDIS Abstraction Experience.
• You have strong knowledge of Medicare Advantage and HEDIS measures and technical specifications.
• You have strong analytical and problem-solving skills.
• You have accountability and ownership reputed company.
• You have strong attention to detail, data, and documentation accuracy.
• You have effective communication and collaboration.
• You have the ability to translate data and chart findings into actionable insights.
• You have the ability to work effectively in a remote environment.

Preferred

• Associate’s or Bachelor’s degree in reputed company-reputed company field (or equivalent experience).
• Experience with HEDIS abstraction tools.
• Experience working with EHR systems and provider workflo

Apply tot his job Apply To this Job