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HEDIS Nurse Reviewer in South Portland at Collabera

Date Posted: 11/7/2018

Job Snapshot

Job Description

The Healthcare Effectiveness Data and information Set (HEDIS) Quality Assurance Nurse Reviewer works under the direction of the HEDIS Quality Assurance Team Lead to Perform Quality Assurance reviews on medical records. The HEDIS Quality Assurance Nurse Reviewer will validate abstracted pertinent medical record data and enter findings electronically into a specified data base to support HEDIS Reporting and Quality Improvement. The candidate may be required to perform other duties toward HEDIS collection and abstraction activities as assigned. This is a fast-paced environment and candidates must adhere to measured productivity requirements such as number of records reviewed each day and/or week. The candidate is required to attain a score of 100% on specific measure testing prior to conducting live medical record reviews and to achieve and maintain a quality reliability score of 95% to remain eligible for employment for the duration of the project.

Job Requirements

• Follow established procedures for conducting Quality Assurance Overread reviews of abstracted medical records • Extract electronic medical record data using multiple systems • Enter pertinent data from paper and electronic medical records into database as required by established quality assurance abstraction procedures • Communicates effectively and professionally • Meet or exceed productivity and accuracy requirements • Ability to work independently and in team environment • Excellent time management and prioritization skills • Excellent communication skills (written and verbal) • Strong attention to detail • Ability to multi-task • Flexibility with assignment change • Highly organized • Evidence of strong computer skills including the MS office suite (e.g., MS Outlook, Excel, and Word) • RN or LPN/LVN • Minimum three years recent HEDIS data abstraction experience required.


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