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RN/ LVN - HEDIS Medical Record Reviewer

Los Angeles, CA

Position: Healthcare

Job Description

RN/ LVN - HEDIS Medical Record Reviewer

Do you know HEDIS? Looking for a way to work with a Fortune 500 company? APPLY NOW!

About the Role:

  • Fully remote working from home, BUT must be located in California!
  • Must have high speed reliable internet; all equipment will be provided

Job Type: Contract Only (HEDIS season)

Job Description:

This position will be in support of the HEDIS Medical Record Review (MRR) cycle. The individuals will work directly with HEDIS MRR Program Manager and other medical record reviewers to review medical record.

  • Primary responsibility will be to perform medical record review, & enter findings into abstraction tool (Inovalon QSHR) and to over read
  • Identify chase opportunities & track progress
  • Coordinate with Program Manager, and administrative staff to manage caseload for teams
  • Communicate with team members to effectively manage project assignment

What we would like to see:

  1. Colorectal Cancer Screening (COL)
  2. Controlling High Blood Pressure (CBP)
  3. Comprehensive Diabetes Care (CDC)
  4. Cervical Cancer Screening (CCS)
  5. Childhood Immunization Status (CIS)
  6. Immunizations for Adolescents (IMA)
  7. Lead Screening in Children (LSC)
  8. Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescent (WCC)
  9. Prenatal and Postpartum Care (PPC)
  10. Transitions of Care (TRC)
  11. Care for Older Adults (COA)

Education Requirements:

  • Preferred RN, LVN/LPN, Certified Medical Assistant or certified coder
  • Preferred with previous 2 years of on-season HEDIS Medical Record Review experiences

Qualifications:

  • Preferred with previous 1-2 years of in-season HEDIS Medical Record Review experience
  • Must be proficient in computers and conducting most/all work activities on computer only
  • Ability to read and navigate clinical medical records in looking for specifically sought information
  • Strong attention to detail and accuracy is essential
  • Ability to maintain a high volume of abstractions

Meet Your Recruiter

Nora Kawaguchi
Program Manager

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