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 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
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 2026 - May 2026
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 2026 - May 2026)
Providence welcomes 100% remote work for applicants who reside in the following states: 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
Required Qualification: 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.