HEDIS Medical Record Reviewer
Title: HEDIS Medical Record Reviewer
Location: Remote, must live in California, prefers candidates to be local to Ventura County to San Jose County.
Description:
Medical record review and data collection, in strict compliance with National Committee for Quality Assurance (NCQA) HEDIS specifications as published in the prevailing HEDIS® Volume 2: Technical Specifications for Health Plans.
HEDIS qualifying data will be entered into the client provided laptop computer. Data collected must accurately match what is documented in reviewed medical records. A minimum cumulative 97% accuracy rate is required for all HEDIS measures, in aggregate for all cases, based on the acceptability of each case outcome for purposes of determining HEDIS measure numerator compliance.
What You Will Do:
Collaborate and continuously coordinate with the HEDIS project team, to assure a successful outcome of the project and HEDIS Compliance Audit.
Conduct HEDIS-related research and medical record review.
Act as HEDIS liaison to providers at which reviews are performed.
Other duties and projects as assigned.
You Will Be Successful If:
Ability to perform HEDIS medical record abstraction and conduct other data collection activities as needed.
High familiarity with medical records, including collection of data from hardcopy records and various EMR systems.
Ability to perform effectively under pressure and maintain focus on daily responsibilities for long-term projects.
Effective oral and written communication and negotiation skills.
Experience reviewing the medical records in the EMR (chart note, lab section, orders, vitals, etc), as well as faxed/scanned records. This involves entering the patient name into the EMR, selecting the correct member, and reviewing the entire medical record for evidence.
Experience entering documentation into the HEDIS software vendor.
What You Will Bring:
Bachelor's Degree in a job-related field, or a combination of academic, professional or work experience that demonstrates ability to perform the duties of the position,
HEDIS medical record data abstraction into a proprietary HEDIS medical record review data collection application, OR medical record or EMR data abstraction experience.
Experience working with the following EMR systems: Athena, NextGen, and Epic preferred. Any other EMR experience is acceptable.
Laptop medical data collection proficiency.
MA, EMT, LVN, or RN certification or licensure, OR Certified Professional in Healthcare Quality (CPHQ) or similar certification preferred.
Knowledge of HEDIS technical specifications, including but not limited to hybrid measure medical record data abstraction requirements preferred.
An emphasis in Medicare or Medicaid/Medi-Cal managed care preferred.
About Impresiv Health:
Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.
Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it.
That's Impresiv!
Apply Now
Location: Remote, must live in California, prefers candidates to be local to Ventura County to San Jose County.
Description:
Medical record review and data collection, in strict compliance with National Committee for Quality Assurance (NCQA) HEDIS specifications as published in the prevailing HEDIS® Volume 2: Technical Specifications for Health Plans.
HEDIS qualifying data will be entered into the client provided laptop computer. Data collected must accurately match what is documented in reviewed medical records. A minimum cumulative 97% accuracy rate is required for all HEDIS measures, in aggregate for all cases, based on the acceptability of each case outcome for purposes of determining HEDIS measure numerator compliance.
What You Will Do:
Collaborate and continuously coordinate with the HEDIS project team, to assure a successful outcome of the project and HEDIS Compliance Audit.
Conduct HEDIS-related research and medical record review.
Act as HEDIS liaison to providers at which reviews are performed.
Other duties and projects as assigned.
You Will Be Successful If:
Ability to perform HEDIS medical record abstraction and conduct other data collection activities as needed.
High familiarity with medical records, including collection of data from hardcopy records and various EMR systems.
Ability to perform effectively under pressure and maintain focus on daily responsibilities for long-term projects.
Effective oral and written communication and negotiation skills.
Experience reviewing the medical records in the EMR (chart note, lab section, orders, vitals, etc), as well as faxed/scanned records. This involves entering the patient name into the EMR, selecting the correct member, and reviewing the entire medical record for evidence.
Experience entering documentation into the HEDIS software vendor.
What You Will Bring:
Bachelor's Degree in a job-related field, or a combination of academic, professional or work experience that demonstrates ability to perform the duties of the position,
HEDIS medical record data abstraction into a proprietary HEDIS medical record review data collection application, OR medical record or EMR data abstraction experience.
Experience working with the following EMR systems: Athena, NextGen, and Epic preferred. Any other EMR experience is acceptable.
Laptop medical data collection proficiency.
MA, EMT, LVN, or RN certification or licensure, OR Certified Professional in Healthcare Quality (CPHQ) or similar certification preferred.
Knowledge of HEDIS technical specifications, including but not limited to hybrid measure medical record data abstraction requirements preferred.
An emphasis in Medicare or Medicaid/Medi-Cal managed care preferred.
About Impresiv Health:
Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.
Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it.
That's Impresiv!
Apply Now