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HEDIS RN Reviewer

Company: Aerotek
Location: Waipahu
Posted on: January 15, 2022

Job Description:


  • Collects data for ambulatory medical record reviews and compliance with provider preventive health and chronic disease outcome improvement interventions.
  • Prepares reports and quality improvement studies in an accurate, concise and timely fashion.
  • Conducts internal auditing for compliance with regulatory and accreditation standards, and monitors and provides consultation to departments to correct deficiencies.
  • Communicates with external data sources as needed to gather data necessary to measure identified outcomes.
  • Provides communication such as newsletter articles, member education, outreach interventions and provider education.
  • Collects and summarizes performance data and identifies opportunities for provider improvement.
  • Participates in site visit preparation and execution by regulatory and accreditation agencies (State agencies, CMS, AAAHC, URAC, NCQA,EQRO).
  • Pursues methods to ensure receipt of data required for trending and reporting of various QI work plan metrics. Assists in activities to prioritize clinical and service improvement initiatives.
  • Ensures that documentation produced and/or processed complies with state regulations and/or accrediting body requirements.
  • Ensures assigned contract/regulatory report content is accurate and that submission adheres to deadline.
  • Performs other duties as assigned.Skills:excel data entry, adobe photoshop, RN, HEDIS, Quality ImprovementTop Skills Details:excel data entry, adobe photoshopAdditional Skills & Qualifications:Education Level: Registered Nurse Experience in a managed care health services environment- Required Experience in data collection and data entry- Required Skill Sets
    • Demonstrated interpersonal/verbal communication skills
    • Ability to multi-task
    • Ability to work in a fast paced environment with changing priorities
    • Ability to implement process improvements
    • Ability to effectively present information and respond to questions from families, members, and provider
    • Technology
      • Microsoft Excel
      • Microsoft Access
      • Microsoft PowerPoint
      • Microsoft OutlookExperience Level:Expert Level About Actalent:Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the globe are making an impact. Were supporting critical initiatives in engineering and sciences that advance how companies serve the world. Actalent promotes consultant care and engagement through experiences that enable continuous development. Our people are the difference. Actalent is an operating company of Allegis Group, the global leader in talent solutions.The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Keywords: Aerotek, Honolulu , HEDIS RN Reviewer, Other , Waipahu, Hawaii

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