HEDIS RN LPN

Following are the position details:

HEDIS 2015 Record Collection- Temps to assist with record collection and data abstractions and/or over-reads.

Location: Candidate will mostly be working onsite on 77 Water Street in NYC. Weekly team meeting onsite on Tuesdays.

Duration: Jan 2016 – July 2016

Willingness to travel within NYC boroughs a must if required, this position may involve working in the office as well as at various client locations as needed.  

Candidates will be driving/travelling to and from locations in the following areas. Candidates from following areas will be preferred, 

Brooklyn

Queens

Manhattan

Bronx 

Staten Island

Long Island-Nassau / Suffolk

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 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

Specific Background Requirements:

RN/LPN

5+ years clinical experience, or other relevant experience

2+ years of quality improvement experience, or other relevant experience

MUST HAVE PRIOR HEDIS EXPERIENCE (at least 1 season) and be knowledgeable on various HEDIS measures.

Must have strong experience using MS Excel, for data entry

Experience working in Medicaid and/or Medicare health care and insurance industry, including regulatory and compliance requirements

• Knowledge base of clinical standards of care, preventive health standards, HEDIS, NCQA, governing and regulatory agency requirements, and the managed care industry. 

• Ability to travel to physician offices if required; valid state-specific driver's license and reliable vehicle.

• Strong organizational skills and ability to work both independently and with teams.

• Ability to evaluate medical records with attention to detail.

• Ability to interact with medical staff, peers, and internal company staff at all levels. 

• Ability to use databases and prepare reports as needed

• Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel. Outlook

• Demonstrated ability to assist with focusing activities toward a strategic direction as well as develop tactical plans, drive performance and achieve targets

• Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action