Judge Healthcare is currently searching for RN's and LPN's with HEDIS experience!
Location: Onsite positions in the San Antonio, Texas area or REMOTE in CST
Schedule: Mon-Fri- 8-5, after hours and Weekend work may be required
Rate: Dependent on Experience
HEDIS Operations combines talented individuals from many areas of quality, including HEDIS, CAHPS and Accreditation. Our goal is extraordinary performance that exceeds the expectations of stakeholders, customers and members we serve.
In this position, you will work with the Quality SDS/PSV Operations staff to assist with data collection of managed care data.
The purposes of this role include, but are not limited to:
1. Market specific data entry and collection
2. Medical record review and abstraction for HEDIS and HEDIS-like measures
3. Other duties as assigned
The candidate must be technically savvy and must be able to work without distraction. This is a high production environment, and candidates must adhere to measured productivity and quality requirements.
- Reviews assigned medical records in order to verify clinical data elements for HEDIS reporting,
- Identifies findings supported by documentation guidelines with high level of accuracy
- Maintains HIPAA standards and confidentiality of protected health information; reports critical incidents immediately.
- Prioritize and organize own work to meet agreed upon deadlines.
- Communicates identification of pursuit leads for additional medical records, if needed, to other members of the team
- Attends conference calls as necessary to provide information relating to clinical reviews and compliance
- Successfully completes HEDIS technical specification training and testing
- Successfully completes HEDIS software training and uses software correctly
- Performs other duties as assigned
- Active Registered Nurse (RN)
- Minimum 2 year HEDIS, Chart chase & Quality experience
- Solid knowledge of managed care requirements related to clinical quality
- Strong medical record review and abstraction prefer