Job Summary
We are in need of nurses, RNs and LPNs, for our annual, HEDIS medical review project. The successful candidate will be able to perform mixed chart reviews, with an expectation of 90% accuracy on Inter-Rater Reliability (IRR) testing.
These are full-time, temporary, remote (work from home) positions expected to run from January 2019 through the end of May 2019. You must be able to participate in daily team meetings via phone conferencing.
Laptop and paid training to the software used will be provided. Must be able to work west coast hours.
Knowledge, Skills and Abilities:
Strong knowledge of clinical content in records to ensure HEDIS compliance.
Knowledge of key drivers to successfully review records for clinical audits.
Ability to evaluate records for accuracy and integrity.
Strong attention to detail.
Strong computer skills.
Effective oral and written communication skills.
Ability to work well with others in a collaborative and respectful manner.
Ability to maintain a professional demeanor.
Ability to maintain confidentiality.
Ability to independently organize and thrive in a fast-paced and changeable environment, and report regularly on overall progress and status.
Able to deal with complexity on a frequent basis.
Ability to be proactive in problem identification and resolution.
Qualification
2+ years medical record review and/or coding for clinical, risk adjustment or other medical auditing required.
5+ years of experience in any health care setting.
Licensure
Active, Unrestricted Nurse License in state of residence
