Knowledge of CMS Regulations and NCQA HEDIS Guidelines; Knowledge of Evidence based Clinical Practice Standards American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)Familiarity with ICD 9, ICD 10 and CPT 4 coding practices; Complete comprehensive, accurate and thorough review of the assigned member population, includin

Knowledge of CMS Regulations and NCQA HEDIS Guidelines; Knowledge of Evidence based Clinical Practice Standards American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)Familiarity with ICD 9, ICD 10 and CPT 4 coding practices; Complete comprehensive, accurate and thorough review of the assigned member population, includin

Work with the agile team to participate in agile ceremonies like grooming, planning, standup, retrospective, demos Actively contribute to grooming, and standup, create & update tasks, estimate and status Write complex queries, stored procedures, functions, SSIS Packages for various job execution Work with data architects and business analysts to create a logical data mode

Knowledge of CMS Regulations and NCQA HEDIS Guidelines; Knowledge of Evidence based Clinical Practice Standards American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)Familiarity with ICD 9, ICD 10 and CPT 4 coding practices; Complete comprehensive, accurate and thorough review of the assigned member population, includin

Knowledge of CMS Regulations and NCQA HEDIS Guidelines; Knowledge of Evidence based Clinical Practice Standards American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)Familiarity with ICD 9, ICD 10 and CPT 4 coding practices; Complete comprehensive, accurate and thorough review of the assigned member population, includin

Knowledge of CMS Regulations and NCQA HEDIS Guidelines; Knowledge of Evidence based Clinical Practice Standards American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)Familiarity with ICD 9, ICD 10 and CPT 4 coding practices; Complete comprehensive, accurate and thorough review of the assigned member population, includin

Provide telephone based end user technical support for office and remote personnel to ensure prompt service restoration of various systems and applications; Display superior customer service with every end user interaction, strong analytical and problem solving skills resulting in first time resolution Exemplify excellent organizational skills with the ability to multi ta

Knowledge of CMS Regulations and NCQA HEDIS Guidelines; Knowledge of Evidence based Clinical Practice Standards American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)Familiarity with ICD 9, ICD 10 and CPT 4 coding practices; Complete comprehensive, accurate and thorough review of the assigned member population, includin

Process, track and monitor client requests across all aspects of Employer's offered services for a) EHR credentialing reviews (if applicable), b) corrective action solutions, c) HEDIS chart abstractions, d) Medicare risk adjustment reviews and e) custom chart abstractions; Work with team to assist and respond to Q & As for the new EHR tasks and implementations; Provide su

Knowledge of CMS Regulations and NCQA HEDIS Guidelines; Knowledge of Evidence based Clinical Practice Standards American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)Familiarity with ICD 9, ICD 10 and CPT 4 coding practices; Complete comprehensive, accurate and thorough review of the assigned member population, includin

Knowledge of CMS Regulations and NCQA HEDIS Guidelines; Knowledge of Evidence based Clinical Practice Standards American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)Familiarity with ICD 9, ICD 10 and CPT 4 coding practices; Complete comprehensive, accurate and thorough review of the assigned member population, includin

Knowledge of CMS Regulations and NCQA HEDIS Guidelines; Knowledge of Evidence based Clinical Practice Standards American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)Familiarity with ICD 9, ICD 10 and CPT 4 coding practices; Complete comprehensive, accurate and thorough review of the assigned member population, includin

Work with the agile team to participate in agile ceremonies like grooming, planning, standup, retrospective, demos Actively contribute to grooming, and standup, create & update tasks estimate and status Design and develop modern data ingestion pipeline utilizing tools like ADF (Azure Data Factory), Databricks, MS SQL Extensively work on Azure Cloud Platform Write complex

Knowledge of CMS Regulations and NCQA HEDIS Guidelines; Knowledge of Evidence based Clinical Practice Standards American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)Familiarity with ICD 9, ICD 10 and CPT 4 coding practices; Complete comprehensive, accurate and thorough review of the assigned member population, includin

Direct responsibility of the day to day and the overall performance, training, and development of the Communication Center Representative team assigned to telephonic member outreach for information collection, coaching and education; Develop, motivate, and assist a team of 10 15 non clinical Call Center Representatives (CCR's) in the problem solving resolution process in