HEDIS Review Nurse
New
H
HireOps StaffingHealthcare quality
United StatesContractJunior
Salary42 USD per hour
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Job Details
- Experience
- 2 years’ HEDIS abstraction/over-reading experience
- Required Skills
- Microsoft ExcelData entry
Requirements
- Hold an unrestricted Registered Nurse (RN) or Licensed Practical Nurse (LPN) license.
- Have 2 years of HEDIS abstraction or over-reading experience.
- Demonstrate data-entry proficiency.
- Have working knowledge of PDF, Word, and Excel.
- Have database management skills.
- Preferred: experience in Pediatrics, Cardiology, Endocrinology, or Obstetrics.
- Preferred: QSHR proficiency.
Responsibilities
- Abstract medical records during the annual HEDIS survey.
- Apply product- and plan-specific criteria during medical record reviews.
- Maintain defined productivity volumes and a 95% accuracy rate during abstraction and data entry.
- Perform quality reviews of abstracted medical records as assigned.
- Manage folders and files, annotate medical records, and save completed documents using the required naming conventions.
- Enter data into QSHR.
- Attend scheduled and ad-hoc meetings with the HEDIS Project Manager and Quality Management Specialist to discuss project status, issues, and productivity.
- Escalate work-related challenges and communicate development or assistance needs to management.
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