Duration: 12 Months Contract + Extension
Job Description: Overview of the open position for HEDIS Review Nurses.
Terms of Employment Contract, 12 Months
This is a hybrid position. This individual must reside in a commutable distance to Owings Mills, MD or the Canton neighborhood of Baltimore, MD for periodic, ad hoc onsite office work. The expectation would be – at most – once per week.
Overview Our client is looking for two HEDIS Review Nurses to report to a Quality Manager. The organization participates in Prospective HEDIS review and typical HEDIS seasonal review. During Prospective HEDIS, six-to-seven thousand charts need to be reviewed during this time period. During HEDIS season, the organization abides by the denominator of a random sample of 411 members. The HEDIS Review Nurse will be responsible for, at a high level, performing medical chart reviews in an effort to identify opportunities to improve measures.
Required Skills & Experience Licensed Practical Nurse (LPN) or Registered Nurse (RN) licensure and 3+ years of experience in HEDIS performing medical chart review.
Experience in HEDIS abstraction.
Experience in acute clinical, case management, discharge planning, or utilization review.
Ability to effectively communicate with internal and external customers.
Ability to work in a team-oriented environment leveraging excellent interpersonal skills.
Experience in using Microsoft Office (Excel, Word, Power Point, etc.) and web-based technology.
Preferred Skills & Experience Bachelor’s degree in Nursing.
Experience using CareSeed software for HEDIS care management.
Experience using EPIC as an EHR solution.
Contacts Preetam Raj
Lead Technical Recruiter
D: 410-505-4857 EXT: 726