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Senior Business Analyst & Project Manager

Brookhaven, GA
... Lead Business Analyst for revenue-generating Healthcare Quality Measures (HCQM) solutions to provide accurate analytics reporting to support multi-organization measures such as NCQA, HEDIS, and National Quality Forum (NQF). oAnticipated go-live ... - Oct 26

Quality Assurance Medical

Lexington, KY
... Evaluator ● Licensing evaluator for nurse’s aide testing 2014-2015 Optum Brentwood, TN RN Clinical Quality Analyst Yearly HEDIS quality assurance and medical record review Strict maintenance of HIPAA medical standards for at home medical record ... - Oct 24

Medical Customer Service

Downers Grove, IL
... Implemented consultation services to IPA’s, and individual group practices on such issues as: marketing strategies, recruitment techniques, patient satisfaction surveys, NCQA, HEDIS measurements, collections enhancement, and Managed Care contract ... - Oct 22

Data Microsoft Office

Fort Lauderdale, FL
... Weekly and monthly run of Tapestry Metrics Daily load of MOOP Quartly Claims Aging CHCUP reporting to AHCA Assist in monthly HEDIS reporting COMMUNICATION: REPORTS/PRESENTATIONS Preparation of statical data Generate reports for financial analysis ... - Oct 19

Project Manager Management

Canada, Pickering, Ontario
... data-driven administrative and operational solutions for those who provide care and those who pay for care IT Project Manager Responsible for running multiple concurrent agile projects under the guidance of PMO for QM Stars and HEDIS projects. ... - Oct 11

Customer Service Representative

Pontiac, MI
... January 2013 - May 2014 Contract employee for BCN/Blue Cross Blue Shield Southfield, MI Assisted Health Coaches with patient health assessment requirements Updated provider records, utilizing shared spreadsheets for annual HEDIS measurements Created ... - Oct 09

Customer Service Project

Atlanta, GA
... Managed outreach for HEDIS and Medicaid/Medicare clients. Customer Service Representative – Verizon Communication Inc. Feb. 2000- April 2010 Responsible for business account management, direct sales, contract negotiations, conflict resolution, data ... - Oct 09

Medical Records

Hialeah, FL
... HEDIS capture as important dimensions of care and better patient care. Process monitoring and billing for each chart and work in the rejected claim. Review medical records to assure proper coding of submitted claims. Conduct a review of medical ... - Oct 08


Columbia, MD
... Coordinate sources/services based on patient needs, Interact with interdisciplinary team, and document all findings 2/2013 – 5/2013 HEALTHSPRINGS, Baltimore, MD HEDIS Nurse Electronically reviewed in-house medical records for all HEDIS measures in ... - Oct 07


Virginia Beach, VA
... Member of the population health board working with HEDIS measures. CHCS/AHLTA/HAIMS/RMS/Carepoint computer experience. Staff Nurse/Night Supervisor Pitman Manor UMH - Pitman, NJ - September 2009 to May 2011 Provided supervision for medical staff and ... - Oct 01
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