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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 reports 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 Performs all duties in a manner which 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 work flow 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.