Description
Home Search Jobs Job Description Nurse assistantContract: Baltimore, Maryland, USSalary: $40.00 Per HourJob Code: 354299End Date: 2024-10-25 Days Left: 26 days, 3 hours leftApplyAbout the Role:
- The Clinical Medical Review Nurse will be responsible for conducting thorough HEDIS overreads in accordance with NCQA guidelines.
- This role will report to the Clinical Support Supervisor - HEDIS and will be an integral part of the Quality Team.
- Additional responsibilities include assisting with Medical Record Retrieval for HEDIS and Risk Adjustment, participating in internal audits for Supplemental Data, and supporting various needs within the Quality Department.
Responsibilities:
- Accurately and efficiently over-read medical record abstractions performed by the HEDIS abstraction staff on a daily basis
- Complete the over-read process in the Software Application, including providing comments if errors are found
- Correct errors identified through over-read process and re-review charts with similar errors
- Identify and report abstraction errors and provide measure re-education to the abstractor
- Utilize various software applications to support HEDIS operations by entering data and changing chase status
- Maintain productivity level as determined by the QI Department - Maintain compliance with all HIPAA and member confidentiality requirements
- Assist with Medical Record Retrieval, Abstraction, and Research during the Medical Record Review Project
- Support Medical Record Retrieval for Risk Adjustment, internal Supplemental Data Audit (PSV), and other Quality and HEDIS related tasks in the off-season
Education Qualification:
- Bachelor's degree in Nursing, Associates Degree in Nursing, Diploma in Nursing
- In Lieu of Education: 10 years of recent HEDIS abstractions/overreads experience in the payer/health insurance side of HEDIS or with a HEDIS vendor
Job Requirement - hedis
- HEDIS
- Nurse
- Nursing
- hospital
- pharma
- remote
- hybrid
- lpn
- rn
- LPN
- RN
- Medical
- MEDIC
Reach Out to a Recruiter - Recruiter
- Email
- Phone
- Dikshita Biswas
- ...@collabera.com
Apply Now