Coding Quality Auditor, HEDIS

Overview

Coding Quality Auditor, HEDIS at Providence Health Plan. This is a seasonal, temporary role affiliated with Providence Health Plan and located in Beaverton, Oregon, with remote work options for eligible states.

• Be responsible for conducting clinical quality audits/overreads for the Quality Department
• Identify and report 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 in a manner that represents Sisters of Providence

• Technical certification/licensure in Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse upon hire
• High School 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); ability to interpret medical terminology
• 2 years — HEDIS, quality management/quality improvement/utilization review auditing experience, including auditing within electronic health records
• 1 year — experience in the medical field as a Medical Assistant, Certified Nurse Assistant, or LPN

• Associate's Degree in Nursing or healthcare-related field;
  Health Information Management degree
• Experience with health plans, project management, data analysis, and/or case review

• This posting is for multiple openings of a Coding Quality Auditor, HEDIS
• Position affiliated with Providence Health Plan; tied to a location and compensation range in Beaverton, Oregon
• Position Type:
  Temporary, Per Diem, Non Benefitted
• Length of Program anticipated to last January 2026 – May 2026
• Work Schedule:
  
  Monday – Friday
• Work Hours Weekly: 40
• Full-time project commitment required during the HEDIS season
• On call/per diem shifts are scheduled as needed
• Providence offers remote work for eligible states (listed below)
• Eligible remote states:
  Alaska, Washington, Montana, Oregon, California, Texas (Levelland, Lubbock or Plainview), New Mexico, Alabama, Arizona, Delaware, Florida, Iowa, Idaho, Michigan, Minnesota, North Carolina, New Jersey, Utah
• Required and preferred qualifications above are subject to change per Providence policy

EEO Statement:
Providence is an equal opportunity employer. We are committed to creating an inclusive workplace and providing equal opportunities for advancement.