Description:
GENERAL SUMMARYResponsible for performing in a consultative style and developing prospectively,a conceptual framework for working with the local medical record review staff in the management of HEDIS medical record review projects. Sets standards that are compatible with NCQA, CMS and State Medicaid requirements for HEDIS reporting. Has sole responsibility for some small to medium size analytical projects.
ESSENTIAL RESPONSIBILITIES
Uses knowledge of HEDIS medical record project management to share best practiceswith CoventryCares of KY to identify opportunities for improvement in local medical record review strategies.Assists in translating needs, issues, and ideas into effective strategies andaction plans. Coordinates team/project activities and schedules. Synthesizesanalysis and identifies key findings.Communicates results/recommendations to project sponsors. Develops creativealternative solutions. Recommends action steps to team and client. Plans andfacilitates meetings. Makes formal presentations.Uses application skills for managing medical record projects in Quality SpectrumHybrid Reporter (QSHR) and QSI applications. Provides technical assistance andtraining to plans and other users on technical aspects and underlying concepts.Develops policies, procedures and guidance on medical record review and projectstandardization.Provides consultation on effective use of local staff, temporary/seasonal staff and/ormedical record review vendors, as applicable.Travel to physician offices in Kentucky required.Performs other duties as required.
Qualifications:
JOB SPECIFICATIONSBachelor s degree or equivalent experience. Master s degree preferred.Significant experience (usually 7-10years) in HEDIS medical record review and HEDISproject managementDemonstrated ability to conduct and interpret quantitative/qualitativeanalysis.Experience in HEDIS medical record review and reporting software, preferably Catalyst/MedAssurant.Substantive knowledge of managed care operations. Excellent clinical knowledgeand skills.Strong written and verbal communication skills.This position requires excellent verbal and written communication, analyticaland report writing skills, proficiency with spreadsheet software, specificallyMicrosoft Excel and the ability to work in a fast paced environment.Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: Louisville, KY, US
Other Locations: ,
Organization: 38500 - Coventry Health & Life-KY
Schedule: Full-time
Job Posting: 2013-08-12 00:00:00.0
Job ID: 1312571
GENERAL SUMMARYResponsible for performing in a consultative style and developing prospectively,a conceptual framework for working with the local medical record review staff in the management of HEDIS medical record review projects. Sets standards that are compatible with NCQA, CMS and State Medicaid requirements for HEDIS reporting. Has sole responsibility for some small to medium size analytical projects.
ESSENTIAL RESPONSIBILITIES
Uses knowledge of HEDIS medical record project management to share best practiceswith CoventryCares of KY to identify opportunities for improvement in local medical record review strategies.Assists in translating needs, issues, and ideas into effective strategies andaction plans. Coordinates team/project activities and schedules. Synthesizesanalysis and identifies key findings.Communicates results/recommendations to project sponsors. Develops creativealternative solutions. Recommends action steps to team and client. Plans andfacilitates meetings. Makes formal presentations.Uses application skills for managing medical record projects in Quality SpectrumHybrid Reporter (QSHR) and QSI applications. Provides technical assistance andtraining to plans and other users on technical aspects and underlying concepts.Develops policies, procedures and guidance on medical record review and projectstandardization.Provides consultation on effective use of local staff, temporary/seasonal staff and/ormedical record review vendors, as applicable.Travel to physician offices in Kentucky required.Performs other duties as required.
Qualifications:
JOB SPECIFICATIONSBachelor s degree or equivalent experience. Master s degree preferred.Significant experience (usually 7-10years) in HEDIS medical record review and HEDISproject managementDemonstrated ability to conduct and interpret quantitative/qualitativeanalysis.Experience in HEDIS medical record review and reporting software, preferably Catalyst/MedAssurant.Substantive knowledge of managed care operations. Excellent clinical knowledgeand skills.Strong written and verbal communication skills.This position requires excellent verbal and written communication, analyticaland report writing skills, proficiency with spreadsheet software, specificallyMicrosoft Excel and the ability to work in a fast paced environment.Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: Louisville, KY, US
Other Locations: ,
Organization: 38500 - Coventry Health & Life-KY
Schedule: Full-time
Job Posting: 2013-08-12 00:00:00.0
Job ID: 1312571