RN Trainer Auditor PRN

61000 SelectHealth Inc; Oklahoma; Remote; USD 49,000 - 73,000; Full time

Job summary

Intermountain Health is seeking a reviewer to abstract medical information for HEDIS audits. You will review records remotely, use an abstraction tool, and ensure documentation aligns with CMS and STARS measures. Collaboration with the HEDIS Manager and data teams is essential.

The role requires an RN license, travel-ready credentials, and 3+ years of clinical experience. Remote work options are available with some on-site interviews as needed.

Qualifications

• RN license in state of practice required.
• Valid driver's license and access to a personal vehicle for local travel.
• Three years of clinical experience in hospital and/or physician office.
• Word processing and spreadsheet skills.
• RNs with less than 12 months of experience must obtain BSN within five years.

Responsibilities

• Review medical records for HEDIS audits using a proprietary abstraction tool.
• Collaborate with HEDIS Manager, Quality Consultants, and Data Analyst.
• Perform remote or offsite medical record reviews with charts from providers.
• Interact with providers and members to gather necessary information.

Skills

RN license

Driver's license

Clinical experience

Computer skills

Education

BSN within 5 years of start date

Bachelor's Degree in Nursing (BSN) preferred

Job description

Job Description

To review medical records retrieved from provider offices and abstract medical information for HEDIS (Health Effectiveness Data Information Set) annual audits. Interprets relevant clinical criteria through review of medical records annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS, CMS, and STARS performance measures. We are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states: California, Connecticut, Hawaii, Illinois, Massachusetts, Maine, Minnesota, New York, Pennsylvania, Rhode Island, Virginia, Vermont, Washington. Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings.

Video phone screens and interview(s) through Microsoft Teams will be required as well for fully remote position.

Job Essentials

Work collaboratively with SelectHealth’s HEDIS Manager, Quality Consultants, and Data Analyst. Responsible for performing accurate and comprehensive medical record reviews using a proprietary abstraction tool and software on an assigned laptop. Reviewer will perform remote or offsite medical record reviews with charts collected from provider offices, clinics and hospitals for the purpose of obtaining documentation to support the HEDIS project. Records will be retrieved by third party vendor, fax, remote EMR access and/or mail processes. Locate and review all assigned medical charts, perform abstraction, mark-up supporting documentation per audit specifications. Proven organizational and time management skills including the ability to meet required deadlines. Work with provider offices as needed to schedule/confirm appointments, and follow up on medical record requests. Calls members to gather procedural information on when and where the member received are and verify care was received. Reviewer must pass a medical record abstraction test prior to beginning the project and will need to maintain minimum competency throughout the project. Frequent interactions with providers, members that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues accurately.

Minimum Qualifications

• Current RN license in state of practice.
• Current driver's license and access to personal vehicle to be able to travel to multiple local offices.
• Three years of clinical experience in hospital, and/or physician office.
• Computer skill in word processing and spreadsheets.
• RNs with less than 12 months of working experience as an RN prior to joining Intermountain must obtain their BSN within five years of their start date.

Preferred Qualifications

• Bachelor's Degree in Nursing (BSN) from an accredited institution.
• Effective organizational skills and written and verbal communication skills.
• Ongoing need for employee to see and read information, assess member needs, and view computer monitors.
• Frequent interactions with providers, members that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues accurately.
• Manual dexterity of hands and fingers, this includes frequent computer use and typing for documenting member care, accessing needed information, etc.

Location

SelectHealth - Murray

Work City: Murray

Work State: Utah

Scheduled Weekly Hours: 0

Salary

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $35.22 - $53.29

Benefits

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits package here.

Equal Opportunity

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

AI and Privacy

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment.

Accessibility

Intermountain Health strives to make the application process accessible to all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact 1-800-843-7820 or email [e-mail]. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

Other Information

Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400+ clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. Join our world-class team and embark on a career filled with opportunities, strength, innovation, and fulfillment. All positions subject to close without notice. Thanks for your interest in continuing your career with our team!