HEDIS Review Nurse – Contract

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🔥 12 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $42 / hour

⏳ Contract/Temporary

🟢 Junior

🟡 Mid-level

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HireOps

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2021

👥 HR Tech

🎯 Recruiter

☁️ SaaS

HR Tech • Recruitment • SaaS

HireOps is a company that provides software and services to optimize recruitment operations for employers. The platform centralizes applicant tracking, interview scheduling, candidate sourcing and collaborative hiring workflows, and offers reporting and integrations with HR systems to reduce time-to-hire and improve hiring quality.

📋 Description

• The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set (HEDIS) survey. • The review nurse is responsible for reviewing and accurately performing comprehensive review of medical records to abstract relevant clinical data during HEDIS. • HEDIS abstractions are completed in accordance with NCQA guidelines and technical specifications. • Additional responsibilities include but not limited to folder and file management, annotating medical records and saving completed documents with correct naming conventions on a shared drive as well as data entry into QSHR. • Maintain defined productivity volumes. • Sustain accuracy rate of 95% during abstraction and data entry throughout the HEDIS survey. • Perform quality reviews of abstracted medical records as assigned. • Ensure open and honest communication with management/designee regarding development or assistance needed throughout project. • Escalate work related challenges/issues to Senior Director or designee. • Attend scheduled daily and ad-hoc meetings with HEDIS Project Manager, and /or Quality Management Specialist/ designee to discuss project status, open issues and productivity. • Comply with HIPAA, PHI, patient confidentiality, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.

🎯 Requirements

• Registered Nurse (RN)/ Licensed Practical Nurse ( LPN ) with unrestricted license • 2 years’ HEDIS abstraction/over-reading experience • Data entry proficiency • Working knowledge PDF, Word and Excel • Excellent written and communication skills • Database management