HEDIS LPN/LVN Reviewer

Orlando, FL 32801

Posted: 01/14/2019 Category: Licensed Practical Nurse Job Number: 24104
Description:
  • Candidate needs to live on the East coast/EDT time zone. They can work remotely; no travel required.
  • Conducts HEDIS reviews of medical record clinical documentation including HEDIS Medical Record Retrieval & Abstraction vendor' s Abstractions are related provider treatment records.
  • Collects data following established procedures and analyzes findings for purposes of continuous quality improvement and for internal and external reporting.
  • Interacts with multiple stakeholders internally and externally.
Duties:
  • Audits and reviews provider clinical documentation and related HEDIS Abstractions for Hybrid Measures performed by HEDIS Medical Record Retrieval and Abstraction vendor against NCQA accreditation standards.
  • Collects, analyzes and prepares clinical record information for health plan' s HEDIS Medical Record Retrieval project.
Requirements/Certifications:
  • LVN/LPN Required.
  • 5+ years of experience working with total quality improvement or a behavioral healthcare background in treatment modalities, psychopharmacology, federal/state regulatory guidelines, performance measurement. Ability to work independently with minimal supervision.
  • Project management skills and demonstrated experience.
  • Licensed clinician with 5 years of healthcare quality improvement experience. 
For more information on this position, please call our office at 877-782-3334.
 

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