Healthcare Consultant II

SGS_JOB_1880

Business Support
 Florida
HEDIS
Microsoft Word
Excel
email
and Adobe reader

Contract - 06+ Months (Contract)

Participates in the audit/overead of the medical record collection and review process for HEDIS quality reporting. Training will be provided prior to the start of the assignment. This position audits and interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and audits data populated within a data collection tool to support compliance with HEDIS and CMS performance measures. Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements. The candidate must be proficient with databases and with conducting 100% of work activities on the computer.

Job Responsibilities:

  • Prior experience in performing chart audits is preferred.
  • Candidate must commit to attending all required training and conference calls assigned for the project.
  • Candidate must return all equipment that is supplied to them in good working condition and in a timely manner at the end of the project
  • Medical knowledge/terminology is required.
  • Ability to read and interpret medical records.
  • Professional demeanor and good work ethic.
  • Computer savvy: Microsoft Word, Excel, email, and Adobe reader required. Know how to save a file to a folder.

Skills:

  • 5 or more seasons of HEDIS experience in reviewing medical records is required

Education/Experience:

  • RN/LVN with an associate or bachelor degree is preferred but not required. Successful HEDIS review experience may be substituted for licensure.

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