Registered Nurse - HEDIS

Role: HEDIS Registered Nurse

W2 Contract: 12 Months

Location: Hybrid in Owings Mills, MD / Canton, MD

• This individual must reside in a commutable distance to Owings Mills, MD or the Canton neighborhood of Baltimore, MD for periodic, ad hoc onsite office work. The expectation would be – at most – once per week.

Overview

Our client is looking for three (3) HEDIS Review Nurses to report to a Quality Manager. The organization participates in Prospective HEDIS review and typical HEDIS seasonal review. During Prospective HEDIS, six-to-seven thousand charts need to be reviewed during this time period. During HEDIS season, the organization abides by the denominator of a random sample of 411 members. The HEDIS Review Nurse will be responsible for, at a high-level, performing medical chart reviews in an effort to identify opportunities to improve measures.

Required Skills & Experience

• Licensed Practical Nurse (LPN) or Registered Nurse (RN) licensure and 3+ years of experience in HEDIS performing medical chart review.
• Experience in HEDIS abstraction.
• Experience in acute clinical, case management, discharge planning, or utilization review.
• Ability to effectively communicate with internal and external customers.
• Ability to work in a team-oriented environment leveraging excellent interpersonal skills.
• Experience in using Microsoft Office (Excel, Word, PowerPoint, etc.) and web-based technology.

Preferred Skills & Experience

• Bachelor’s degree in Nursing.
• Experience using CareSeed software for HEDIS care management.
• Experience using EPIC as an EHR solution.
• Experience in direct patient care.