HEDIS QI Retriever
About this role
Company Description
Why You Should Work For Us:
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
- Collects data for ambulatory medical record reviews and compliance with provider preventive health and chronic disease outcome improvement interventions.
- Prepares reports and quality improvement studies in an accurate, concise and timely fashion.
- Conducts internal auditing for compliance with regulatory and accreditation standards, and monitors and provides consultation to departments to correct deficiencies.
- Communicates with external data sources as needed to gather data necessary to measure identified outcomes.
- Provides communication such as newsletter articles, member education, outreach interventions and provider education.
- Collects and summarizes performance data and identifies opportunities for provider improvement.
- Participates in site visit preparation and execution by regulatory and accreditation agencies (State agencies, CMS, AAAHC, URAC, NCQA,EQRO).
- Pursues methods to ensure receipt of data required for trending and reporting of various QI work plan metrics. Assists in activities to prioritize clinical and service improvement initiatives.
- Ensures that documentation produced and/or processed complies with state regulations and/or accrediting body requirements.
- Ensures assigned contract/regulatory report content is accurate and that submission adheres to deadline.
- Performs other duties as assigned.
Qualifications
- Can be RN/LPN / Medical Coder / Medical Records Specialist
- 3+ years experience with HEDIS measurements and HEDIS auditing preferred
- Managed Care Experience
- Experience with Customer Service, data collection and data entry
- Bachelor’s Degree or equivalent clinical work experience.
- Experience with MS Excel, Access, Power Point, Outlook
- Ability to multitask, work in a fast-paced environment with changing priorities, implement process improvements, and effectively present information and respond to questions from families, members, and providers.
- Interpersonal/verbal communication skills
- Medical terminology and/or experience with CPT & ICD-9 coding
Additional Information
Hours:
Monday-Friday daytime hours, 40 hours
Compensation:
negotiable depending on relevant experience/ license
Interested in hearing more about this great opportunity? Please click Apply Now!
Courtney Phelps
407-636-7030 ext 232
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