Tennessee Licensed Quality Auditor
Job Summary
To support quality improvement initiatives, the part-time Tennessee Licensed Quality Auditor will apply structured auditing criteria to abstract medical records and enter results into the health plans database while maintaining compliance with applicable regulations in a remote setting.
Key responsibilities
- Abstract medical record documentation for HEDIS measures and ensure accuracy in data entry
- Maintain productivity levels with less than a 5% error rate in record abstraction
- Communicate effectively with management regarding developments in assigned responsibilities and perform special projects as needed
Required qualifications
- Registered Nurse (RN) or Licensed Practical Nurse (LPN) with an unrestricted license in Tennessee
- 3+ years of relevant experience in utilization review or quality assurance
- Knowledge of medical terminology and federal/state regulations related to quality improvement
- Experience with HEDIS abstraction and medical record audits
- Proficiency in PC applications, including Word and Excel
Complete Job Description
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