HEDIS Reviewer
3 weeks ago
Job Title: HEDIS Retriever
Department: Quality Management
Location: New York, NY – 10004 (Hybrid, 3 days per week onsite)
Duration: 3 Months
Purpose of Position:
The HEDIS Retriever - Seasonal plays a crucial role in the annual Medical Record Review project, focusing on onsite abstraction of services from medical charts to comply with HEDIS/QARR and Medicare Advantage Star measure specifications. This field-based, seasonal role operates from November through May, and involves traveling within the five boroughs of New York City. The role is essential for reporting HEDIS and QARR measures to the NYS Department of Health and Centers for Medicare & Medicaid Services (CMS).
Scope of Role & Responsibilities:
- Medical Record Review: Maintain proficiency in reviewing medical records and Electronic Medical Record (EMR) systems.
- Compliance Knowledge: Stay updated on HEDIS, QARR, and Star specifications to ensure compliance.
- Technical Skills: Utilize MS Office applications for data entry and documentation, and ensure accurate input into systems.
- Administrative Duties: Distribute record requests, schedule provider office appointments, and ensure timely record collection to meet internal and regulatory standards.
- Abstraction: Conduct abstraction of medical records via EMR, paper records, and onsite provider visits to document measure compliance.
- Data Entry: Enter findings accurately and timely into the appropriate systems, maintaining established documentation standards for .
Required Education, Training & Professional Experience:
- Education: High School diploma or GED.
- Experience: Minimum of two years in HEDIS review. Clinical background (Medical Assistant, Nursing Assistant, Health Educator, LPN, RN, LMSW, or LCSW) preferred.
- Experience with HEDIS/QARR: Previous work experience in a managed care, health plan, or provider office setting with HEDIS/QARR.
- Technical Skills: Proficient in Microsoft Office applications, including Word, Excel, PowerPoint, and Access.
Travel Requirements: Daily travel within the five boroughs of New York City is required.
Application Instructions: Please submit your resume and cover letter outlining your relevant experience and qualifications.
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