A Special Project Nurse/Medical Professional will be responsible for completing auditing and/or medical records review projects. Responsibilities includes medical records reviews, data collection, chart abstractions, reporting and analyses. Must have good communication skills to interface with United Health Services personnel and be very detailed oriented. This position is responsible for HEDIS data collection and reports to the Quality Management Manager.
Coordinates and performs onsite medical record reviews medical record collection at provider offices
Supports the HEDIS medical record chase to support optimum HEDIS and quality metric reporting.
Supports quality improvement, requesting records from providers, maintaining databases, and researching to identify members' provider encounter history
Enter documentation of findings in identified database