Join to apply for the Coding Quality Auditor, HEDIS role at Providence
3 days ago Be among the first 25 applicants
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.
Responsibilities
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
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
Required Qualifications
Technical certification/licensure in the area of Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse upon hire.
H.S. Diploma or GED.
3 years - Medical record audit experience, experience with extraction of clinical data points from medical records, experience with electronic medical records (EMR), comfortable with use of technology. Ability to interpret and understand medical knowledge/terminology in a medical record.
2 years - HEDIS, Quality management/quality improvement/utilization review auditing experience, including experience in auditing within electronic health records.
1 year - Experience in the medical field as a Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse (LPN).
Preferred Qualifications
Associate's Degree - Nursing or Healthcare related field, Health Information Management degree.
Experience with health plans, project management, data analysis, and/or case review.
Remote Locations
Alaska
Washington
Montana
Oregon
California
Texas - Levelland, Lubbock or Plainview area
New Mexico
Alabama
Arizona
Delaware
Florida
Iowa
Idaho
Michigan
Minnesota
North Carolina
New Jersey
Utah
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.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
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.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 398068
Company: Providence Jobs
Job Category: Coding
Job Function: Revenue Cycle
Job Schedule: Part time
Job Shift: Multiple shifts available
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
Workplace Type: Remote
Pay Range: $35.66 - $55.37
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Quality Assurance
Hospitals and Health Care
Referrals increase your chances of interviewing at Providence by 2x
Get notified about new Quality Auditor jobs in Plainview, TX.
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.