HEDIS RN Reviewer
Posted on: January 15, 2022
- 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,
- 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
- 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
- Ability to implement process improvements
- Ability to effectively present information and respond to
questions from families, members, and provider
- Microsoft Excel
- Microsoft Access
- Microsoft PowerPoint
- Microsoft OutlookExperience Level:Expert Level About
Actalent:Actalent connects passion with purpose. Our scalable
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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
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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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