20 Hedis Jobs

We are seeking a highly skilled Technical Analyst with deep knowledge of Cozeva, a comprehensive healthcare analytics platform. The candidate should also be a Subject Matter Expert (SME) in value-based care healthcare lines of business, including risk delegation, attestations, Hierarchical Chronic Conditions (HCC), and recapture concepts, with a contextual understanding of how these are implemented in the Optum Ecosystem. Additionally, the candidate should be an expert in Quality healthcare lines of business, including HEDIS (Healthcare Effectiveness Data and Information Set) and non-standard quality measures, with in-depth knowledge of inclusion, exclusion, and methods of satisfying these m...

Job Title: HL7 AI/Data Analyst Location: Coimbatore Client: Optum Job Type: Full time Notice: Immediate JD details: Key Responsibilities: Data Management & Governance: Ensure data accuracy, integrity, and compliance with healthcare regulations. Perform analyses to support clinical, operational data Strategic Collaboration: Translate business questions into analytic requirements. Partner with internal teams and external providers to deliver insights. Healthcare-Specific Focus Areas: Contribute to regulatory reporting , value-based care metrics , and clinical performance benchmarking Required Qualifications: 35+ years of experience in data analytics or a related field. Strong proficiency in SQ...

Walk-In Interview for Experienced Medical Coders at Vee Healthtek, Hyderabad on October 10 & 11 Experience : 1+ Years experience on medical coding Specialty : IP DRG/Surgery/EM/ED/Denials/Hedis/Radiology/IVR/Radiation Oncology- Medical Coding Job Location : Hyderabad,Chennai, Bangalore, Salem,Trichy, & Pune - Work From Office Designation : Medical Coder/Sr Coder/QA/GC/TL AAPC Certification is Must Interview Schedule : October 10 & 11 at 10:00 AM TO 1PM Interview Venue: Vee Healthtek Pvt Ltd, Dream Center, Preston Prime Mall, 3rd Floor, Lumbini Avenue, Gachibowli, Hyderabad, Telangana 500081. Important Note : Please mention my name, Vanitha HR as Reference, at the top of your resume. Contact ...

GREETINGS FROM GEMS CONSULTANCY HIRING FOR MEDICAL CODERS LOCATION:-BANGALORE,CHENNAI,HYDERABAD,SALEM,PUNE,TIRCHY IMMDIATE JOINERS ONLY EXP-1 TO 5 YEARS INTERESTED CANDIDATES CALL ASHA-9603228414 globaledge07@gmail.com

Walk-In Interview for Experienced Medical Coders at Vee Healthtek, Hyderabad on October 10 & 11 Experience : 1+ Years experience on medical coding Specialty : IP DRG/Surgery/EM/ED/Denials/Hedis/Radiology/IVR/Radiation Oncology- Medical Coding Job Location : Hyderabad,Chennai, Bangalore, Salem,Trichy, & Pune - Work From Office Designation : Medical Coder/Sr Coder/QA/GC/TL AAPC Certification is Must Interview Schedule : October 10 & 11 at 10:00 AM TO 1PM Interview Venue: Vee Healthtek Pvt Ltd, Dream Center, Preston Prime Mall, 3rd Floor, Lumbini Avenue, Gachibowli, Hyderabad, Telangana 500081. Important Note : Please mention my name, Ramesh HR as Reference, at the top of your resume. Contact I...

Greetings from GEMS Consultancy Hiring for Medical coder Experience: 1- 5 yr Location : Bangalore Hyderabad Tamilnadu Pune Immediate Joiners only Interested candidates can share their resume Pavithra B 7019144304 gemsconsultancy01@gmail.com

We are seeking a highly motivated and clinically experienced Medical Clinician to join our team, contributing to our efforts in transforming healthcare delivery through Value-Based Care (VBC) initiatives. The ideal candidate will have a deep understanding of the U.S. healthcare system, a strong clinical background, and a passion for leveraging data to drive better health outcomes and cost efficiencies. This role bridges clinical knowledge with analytics, supporting strategic decision-making and operational excellence across value-based care programs. Requirements Clinical Strategy & Support This is a Client Facing role and requires strong command of English to be able to: Provide clinical in...

As a Healthcare Business Analyst at HCT, the technology wing of Sagility Healthcare, you will play a crucial role in analyzing, designing, and optimizing business processes for healthcare systems. Your primary responsibilities will include: - Acting as a liaison between business stakeholders and IT to gather, analyze, and document business requirements, providing technology solutions related to healthcare systems. - Analyzing complex healthcare data sets such as EDI, claims, eligibility, utilization, and quality metrics to identify trends, gaps, and opportunities. - Developing detailed business requirement documents (BRDs), functional specifications, process flows, and use cases. - Translati...

Gainwell Technologies LLC Summary Your role in our mission Essential Job Functions Assists in planning and designing business processes; assists in formulating recommendations to improve and support business activities. Assists in analyzing and documenting client's business requirements and processes; communicates these requirements to technical personnel by constructing basic conceptual data and process models, including data dictionaries and volume estimates. Assists in creating basic test scenarios to be used in testing the business applications in order to verify that client requirements are incorporated into the system design. Assists in developing and modifying systems requirements doc...

Immediate Job Openings for Certified HEDIS Medical Coders @ Vee Healthtek,Hyderabad Job Description: 1+ Years of Experience in Hedis Medical Coding. Specialty: Hedis Medical Coding Experience: 1 - 4 Years. Designation: Medical Coder/ Sr Coder/QA Certification: CPC/COC/CCS/CIC/CRC is Must Salary: 35K CTC Max Joining: Immediate Joiners only Location: Hyderabad - WFO Interested Candidate can Call Immediately to 9443238706 (Available on Whatsapp) or forward your profile to ramesh.m@veehealthtek.com Regards, Ramesh - HRD 9443238706 ramesh.m@veehealthtek.com Vee Healthtek

Role & responsibilities PRINCIPLE JOB RESPONSIBILITIES: Accountable for all assigned personnel management activities, including overseeing the day-to-day operations of assigned team Accountable for the employment, timely performance evaluation, counselling, employee development, and discipline of assigned employees Accountable for management of assigned employees time keeping and PTO Conduct applicant interviews and screening Good understanding and ability to explain care management business processes Utilization Management, Disease Management, Case Management, Member Services and Appeals Good understanding and ability to explain Medicare and Medicaid business processes Establish and manage ...

As a Data Analyst with deep experience in the US Healthcare industry and skills around Machine Learning (ML), you will play a vital role in conducting comprehensive data analysis using statistical and exploratory methods to uncover patterns and insights that drive data-driven decision-making in the healthcare domain. Leveraging your knowledge of healthcare industry metrics such as HEDIS, CMS Star Ratings, risk adjustment models, and revenue cycle data, you will optimize analytics strategies to ensure efficient data quality, availability, and reliability for AI/ML-driven healthcare analytics solutions. Your responsibilities will include designing and maintaining data pipelines for the ingesti...

Job Title: Risk Adjustment Coder Location: Kolkata Job Type: Full-time Job Overview: Seeking skilled individuals for our medical coding team to conduct retrospective and concurrent chart reviews. Use HCC coding expertise to translate, input, extract, and validate medical data. Collaborate with Certified Risk Coders and Supervisors to ensure accurate diagnosis documentation and HCC abstraction through daily chart reviews. Responsibilities: Collaborate with Certified Risk Coders and Supervisors on daily chart reviews. Demonstrate strong ICD-10 coding knowledge. Follow client-specific guidelines and updates for chart coding. Exhibit strong qualitative and analytical skills. Possess knowledge of...

Roles and Responsibilities : Any graduate with minimum 1.2 years of experience in HCC Coding HEDIS experience candidates are preferrable Should have active coding credentials through AAPC/AHIMA is Mandatory Experience in HCC record abstraction and coding required Demonstrate high level of quality in clinical coding work, identifying and validating HCC mapped diagnoses that are revenue generating Adherence to official coding guidelines, coding clinic determinations, client specific coding guidelines, CMS and other regulatory compliance guidelines and mandates. Experience in medical record validation of correct coding procedures and guidelines Identified by accuracy of 95% or above and consist...

POSITION SUMMARY The Senior MD Analyst is responsible for supporting the development and design of clinical information systems and treatment protocols for the deployment of ZeOmega's Jiva platform. The role is responsible of abstraction, analysis and submission of clinical data. This position will work on the quality and coordination of data collection, entry, analysis, submission, report preparation, presentation of data, data sharing for process improvement initiatives, bench marking and outcomes research. This position communicates the report findings to others throughout the organization, including recommendations for improvements and focused studies. Works in partnership with ZeOmega l...

Cotiviti Hiring HCC Medical Coders For Coimbatore & Hyderabad for HEDIS Department: HCC Coding Role: Medical Coder / Sr Medical Coder Job Location: Coimbatore & Hyderabad Eligibility Criteria: Any graduate with minimum 1.2 years of experience in HCC Coding HEDIS experience candidates are preferrable Should have active coding credentials through AAPC/AHIMA is Mandatory Experience in HCC record abstraction and coding required Demonstrate high level of quality in clinical coding work, identifying and validating HCC mapped diagnoses that are revenue generating Adherence to official coding guidelines, coding clinic determinations, client specific coding guidelines, CMS and other regulatory compli...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Primary Responsibilities: Lead a team of 25-30 certified coders. Maintains staff by recruiting, selecting, orientin...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Primary Responsibilities Lead a team of 25-30 certified coders. Maintains staff by recruiting, selecting, orienting...

Role: Product Owner Product Owner Key Responsibilities: Define and communicate the product vision and strategy. Lead the product development lifecycle from ideation to launch, ensuring alignment with business goals and user needs. Collaborate with engineering teams to prioritize features and manage the product backlog effectively. Conduct research and competitive analysis to identify trends, opportunities, and potential areas for product enhancement. Engage with healthcare payers leaders, and regulatory bodies to gather insights and feedback on product performance and usability. Monitor and analyze product performance metrics to inform decision-making and drive continuous improvement. Foster...

Urgent Hiring: Python Developer -Rule Engine Company : Collance Technology Pvt Ltd. Collance Technologies , is a subsidiary of Care Connectors based in USA . We are into developing/Creating Saas based product for US healthcare domain Location : Noida Sector 62 Exp: 1-5 yrs Role: Develop and maintain a scalable Python-based rule engine, translate business rules into system logic, integrate with existing platforms, ensure performance, security, and maintainability. Key Skills: Strong Python, OOPs, Data Structures, Algorithms Frameworks: FastAPI, Flask, Pandas, JSON, Requests, PyUnit Experience with rule engine tools: Drools, IBM ODM, FICO Blaze, Camunda DMN SQL, REST APIs, AWS (S3, SQS, SNS, C...