All jobs → Partner boards

Quality Audit Specialist

VIVA • Remote, US • published 2026-11-10 06:59:56.066483

Description

Fully remote in any state except NY, CA, HI or AK This position supports the data collection of HEDIS clinical data set tied to technical specifications; auditing and review of electronic clinical records to ensure data accurately reflect medical record documentation to meet HEDIS regulatory compliance. Responsible for oversight and review of clinical data from Electronic Medical Records (EMRs) non\-EMRs sources; auditing supplemental data files supplied by providers and vendors to improve HEDIS rates/results. This position impacts the integrity of the Medical Record validation process and HealthCare Effective Data \& Information Set (HEDIS) Reporting. Individual must demonstrate strong multi\-tasking setting priorities based upon minimal direction including: Strong Knowledge of Healthcare Effective Data \& Information Set (HEDIS) type of reporting Minimum of 3 year’s Healthcare industry experience; healthcare data Strong experience with NCQA and HEDIS reporting, technical data analysis in formal audit formal audit environment. Understanding of NCQA HEDIS quality measures and related code value sets. Experience in HEDIS value sets and codes applied, including CPT II, SNOMED, LOINC,...

Get jobs like this daily in Telegram: @careeri_bot