Coding Quality Auditor, HEDIS Remote

Providence Health & Services • California, MO, United States • $200k - $250k / year • 1w ago

Description

Providence Health Plan caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:

Be responsible for conducting clinical quality audits/overreads for the Quality Department
Identify and report issues related to clinical audits to determine potential areas for quality improvement within the HEDIS project
Collect data by way of chart extraction, using objective specifications for the Healthcare Effectiveness and Data Information Set (HEDIS) program
Conduct audits inclusive of review of outpatient medical records, hospital records, clinical lab, and pharmacy records
Be responsible for collecting data based on standardized methodologies
Organize the data to identify and address opportunities for improvement
Perform chart audits electronically during the audit season
Complete HEDIS training prior to performing chart abstractions
Be provided direction regarding charts requiring auditing
Maintain all collected records in a confidential manner
Perform all duties in a manner that promotes team concept and reflects the Sisters of Providence mission and philosophy
Communicate in a collaborative manner with clinic and other staff with whom they interact, in a manner that represents Sisters of Providence

Please note the following important detail regarding this HEDIS Seasonal Role:

This posting is for multiple openings of a Coding Quality Auditor, HEDIS
This position is affiliated with Providence Health Plan and will be tied to a location and compensation range in Beaverton, Oregon
Position Type: Temporary, Per Diem, Non Benefitted
Length of Program Anticipated to last between: January 2025 - May 2025
Work Schedule: Monday - Friday
Work Hours Scheduled Weekly: 40
Additional Info:
This position will require a full-time commitment to the project, meaning no extended time off during the HEDIS Season (January 2025 - May 2025)
Positions specified as “on call/per diem” refer to employment consisting of shifts scheduled on an “as needed basis” to fill in for staff vacancies.

Providence welcomes 100% remote work for applicants who reside in the United States.

Note: Providence is not currently considering applicants who reside in the following States:

Colorado
Hawaii
Massachusetts
New York
Ohio
Pennsylvania

Required qualifications for this position include:

HS Diploma or GED Equivalency
Licensure / Certification: Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse
1+ years' experience in the medical field as a Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse (LPN)
3+ years of medical auditing experience
3+ years' experience with extracting clinical data points from medical records
3+ years' experience with electronic medical records (EMR)
3+ years' experience using technology in day-to-day workflow
3+ years' experience interpreting and understanding medical knowledge/terminology in a medical record
2+ years of HEDIS experience
2+ years' experience working with quality management / quality improvement in a nursing work environment
2+ years' experience with utilization review audits
2+ years' experience auditing within electronic health records

Preferred qualifications for this position include:

Associates Degree in Nursing or Healthcare field, Health Information Management
Experience working with health plans, project management data analysis and or case review

Why Join Providence Health Plan?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard, and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas, and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Requisition ID: 313775
Company: Providence Jobs
Job Category: Coding
Job Function: Revenue Cycle
Job Schedule: Part time
Job Shift:
Career Track: Business Professional
Department: 5018 HCS QUALITY MANAGEMENT OR REGION
Address: OR Beaverton 3601 SW Murray Blvd
Work Location: Murray Business Ctr Beaverton-Beaverton
Pay Range: $34.96 - $55.34

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