Blue Cross & Blue Shield of Rhode Island · 2 days ago
Seasonal HEDIS Reviewer
Providence, RI
Full-time
Hybrid
Entry, Mid Level
$35/hr - $45/hr
2+ years expBlue Cross & Blue Shield of Rhode Island is dedicated to serving the healthcare needs of Rhode Islanders. They are seeking a Seasonal HEDIS Reviewer to coordinate medical record-related tasks for the Healthcare Effectiveness Data Information Set (HEDIS) and ensure that medical record reviews meet quality measures.
Insurance
Responsibilities
Perform chart audits for medical record review portions of the annual HEDIS audit
Participate in training on hybrid HEDIS measures and data documentation systems
Coordinate project-related tasks for HEDIS activities across the organization
Support HEDIS Manager to ensure all deliverables are accurately completed and meet intended quality
Utilize various data and information systems supporting these activities
Work with technical staff on maintenance of data, and the utilization of various systems to maximize the clinical and business benefits of effective information management
Assist team with department initiatives and projects
Perform other duties as assigned
Qualification
Required
Associate degree; or an equivalent combination of education and applicable work experience
2-4 years of experience in conducting medical record review audit
Extensive knowledge of medical terminology
Working knowledge of Microsoft Office including Excel, and Word
Computer proficiency
Working knowledge of Adobe Acrobat
Written and verbal communications skills
Good organization skills
Time management skills
Detail oriented
Ability to research and organize data
Ability to organize work efficiently to meet established time and quality standards
Preferred
Nurse license, RN or LPN
Knowledge of HEDIS
Proficiency with Microsoft Suite of products; i.e., Word, Excel, PPT, etc
Experience in the health insurance industry
Benefits
Flexible work arrangements
Remote and hybrid opportunities
Paid time off
Tuition reimbursement
Student-loan repayment
Health insurance
Dental insurance
Vision insurance
Programs that support your mental health and well-being
Bonuses
Investment plans
Additional paid time to volunteer
Company
Blue Cross & Blue Shield of Rhode Island
At Blue Cross & Blue Shield of Rhode Island (BCBSRI), we know that health is more than what happens at the doctor’s office.
501-1000 employees
H1B Sponsorship
Blue Cross & Blue Shield of Rhode Island has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (4)
2024 (4)
2023 (2)
2022 (4)
2021 (3)
Funding
Current Stage
Late StageLeadership Team
Martha Wofford
President and CEO
James Joy
Chief Financial Officer - Retired
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