Travel Technician in New York City, NY

7 days ago

Prince, United States Cynet Health Full time
**Job Title:** HEDIS Quality Reviewer
**Job Specialty:** Quality Management
**Job Duration:** 9 months
**Shift:** Day Shift, 9am - 5pm, (Hybrid)
**Guaranteed Hours:** 40 hours per week
**Experience:** 3-5 years in Quality Improvement in a healthcare and/or managed care setting strongly preferred
**License:** Clinical background preferred (Health Educator, RN, LPN, LMSW or LCSW, or Foreign Medical Graduate) with a minimum of three years relevant work experience
**Certifications:** Not specified
**Must-Have:**
- Knowledge of HEDIS and QARR specifications
- Experience using EMR systems, e.g., EPIC, Quadramed
- Proficient in Microsoft Office applications including Word, Excel, PowerPoint, and Access
- Knowledge of ICD-10 and CPT codes preferred

**Job Description:**

- Maintain knowledge of medical record review and EMR systems.
- Keep up-to-date with HEDIS, QARR, and Star specifications.
- Distribute requests for records and schedule appointments with provider offices to ensure timely completion of duties.
- Perform clinical audits via EMR, in-house paper medical records, and on-site provider visits to measure compliance with preventive health guidelines and quality improvement initiatives.
- Identify, track, and report variation from standards of care by auditing core operations, patient care processes, and medical record documentation.
- Design interventions to drive improvement and minimize deviation from standards of care.
- Enter accurate and timely clinical quality findings in the appropriate system(s) according to established documentation standards.
- Assist in the implementation of quality improvement activities as directed by quality management programming needs.
- Support interdepartmental teams focusing on process improvement projects and outcomes.
- Provide educational support to physicians and staff to increase process improvement and enhance member satisfaction, retention, continuity of care, and HEDIS/QARR improvement activities.
- Facilitate retrieval of medical record documentation and collaborate with provider groups and in-field navigators to retrieve electronic and paper records supporting HEDIS/QARR.
- Record findings of patient encounters, including patient identifiers and relevant information, in the database.
- Participate in the annual HEDIS and QARR hybrid medical record review project:
- Work with provider offices to facilitate request and review of charts
- Support temporary staff in the review of medical records (electronic and paper-based)
- Serve as a final reviewer of HEDIS and QARR records
- Ability to travel within the service area as required.

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