HEDIS Review Nurse — Precise Data Abstraction (Contract)

HireOps Staffing; United States; Remote; USD 55,000 - 61,000; Full time

Job summary

HireOps Staffing is seeking a Review Nurse for a fast-paced contract assignment starting immediately and ending April 30, 2024. The role focuses on medical record abstractions and overreads during the HEDIS survey, following NCQA guidelines and specifications.

Responsibilities include abstracting records, applying criteria, maintaining productivity and 95% accuracy, performing quality reviews, and ensuring HIPAA compliance.

Qualifications

• RN or LPN with unrestricted license and current credentials.
• 2 years HEDIS abstraction/over-reading experience.
• Proficient data entry and basic software skills.
• Excellent written and verbal communication abilities.
• HIPAA and patient confidentiality familiarity.

Responsibilities

• Abstract medical records for HEDIS review.
• Apply product/plan specific abstraction criteria during review.
• Maintain defined productivity volumes.
• Sustain accuracy rate of 95% during abstraction and data entry.
• Perform quality reviews of abstracted records.
• Communicate clearly with management/designee; escalate issues as needed.

Skills

HEDIS abstraction

Communication skills

Data entry

Documentation

Education

RN/LPN license

Tools

PDF

Word

Excel

Job description

HireOps Staffing is seeking a Review Nurse for a fast-paced contract assignment starting immediately and ending April 30, 2024. The role focuses on medical record abstractions and overreads during the HEDIS survey, following NCQA guidelines and specifications.

Responsibilities include abstracting records, applying criteria, maintaining productivity and 95% accuracy, performing quality reviews, and ensuring HIPAA compliance.