HEDIS Review Nurse - Remote - Contract

HireOps Staffing is hiring a review nurse for a contract assignment doing medical record abstraction and overreads during the annual Healthcare Effectiveness Data and Information Set (HEDIS) survey. The role is remote and open to nurses in the United States. The assignment starts right away and ends April 30, 2024.

This is a fit for an RN or LPN with at least two years of HEDIS abstraction or over-reading experience who can hold a steady accuracy rate and keep up with defined productivity volumes through the survey.

What you will do

• Abstract medical records and overread them during the HEDIS survey
• Review and accurately perform a full review of medical records to abstract relevant clinical data, following NCQA guidelines and technical specifications
• Apply product and plan specific abstraction criteria and requirements during the review process
• Maintain defined productivity volumes
• Sustain a 95% accuracy rate during abstraction and data entry throughout the survey
• Perform quality reviews of abstracted medical records as assigned
• Handle folder and file management, annotate medical records, and save completed documents with correct naming conventions on a shared drive
• Enter data into QSHR
• Attend scheduled daily and ad-hoc meetings with the HEDIS Project Manager and/or Quality Management Specialist or designee to discuss project status, open issues, and productivity
• Raise work-related challenges or issues to the Senior Director or designee
• Keep communication open and honest with management or designee about development or assistance needed during the project
• Comply with HIPAA, PHI, patient confidentiality, Diversity Principles, Corporate Integrity, Compliance Program policies, and other applicable corporate and departmental policies
• Take on other duties as assigned

What they are looking for

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

Preferred skills

• Experience in Pediatrics, Cardiology, Endocrinology, and/or Obstetrics
• QSHR proficiency

Pay and schedule

The pay is $42 per hour. This is a contract assignment that starts right away and ends April 30, 2024. The role is remote, based in the United States.