Coding Quality Auditor, HEDIS Remote - Many States Eligible
About the position _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 _Please note the following important detail regarding this HEDIS Seasonal Role:_ + 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) + Positions specified as "on call/per diem" refer to employment consisting of shifts scheduled on an "as needed basis" to fill in for staff vacancies. 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
Responsibilities
- 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
Requirements
- 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).
Nice-to-haves
- Associate's Degree - Nursing or Healthcare related field, Health Information Management degree.
- Experience with health plans, project management, data analysis, and/or case review.
Benefits
- Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
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