Remote Quality Nurse — HEDIS & Care Management

Jefferson Health; United States; A distancia; USD 75.000 - 110.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical insurance

Tuition assistance

Flexible spending accounts

Descripción de la vacante

Jefferson Health in Philadelphia, PA seeks a STAR-HEDIS Quality Nurse to support Quality Management by obtaining, reviewing, and abstracting medical record documentation to close care gaps for HEDIS, CMS STAR Ratings, PCMH, and Pay-for-Performance (P4P) measures. This role requires advanced experience navigating multiple EMR systems and performing detailed medical record reviews.

You will collaborate with providers and offices to obtain medical records, conduct electronic retrieval, outreach,

Formación

• 3 years quality management, HEDIS abstraction, clinical audit, or managed care.
• Medical record review and abstraction experience.
• Demonstrated experience navigating multiple EMR systems.
• Prior HEDIS abstraction or chart review experience strongly preferred.
• Advanced proficiency with EMR navigation and documentation review.

Responsabilidades

• Obtain, review, and abstract medical record documentation to close care gaps for HEDIS, CMS STAR Ratings, PCMH and P4P measures.
• Collaborate with colleagues and provider offices to obtain medical records and ensure complete documentation.
• Interface with QM, care management systems, and data repositories to support audits and quality measurement.

Conocimientos

EMR navigation

HEDIS knowledge

Attention to detail

Time management

Written & verbal communication

Independence in remote work

Educación

Associate’s Degree RN or LPN (PA)

Bachelor’s Degree (preferred)

Herramientas

EMR systems

Salesforce

Natural Language Processing systems

Descripción del empleo

Jefferson Health in Philadelphia, PA seeks a STAR-HEDIS Quality Nurse to support Quality Management by obtaining, reviewing, and abstracting medical record documentation to close care gaps for HEDIS, CMS STAR Ratings, PCMH, and Pay-for-Performance (P4P) measures. This role requires advanced experience navigating multiple EMR systems and performing detailed medical record reviews.

You will collaborate with providers and offices to obtain medical records, conduct electronic retrieval, outreach,