HEDIS RN Specialist
4 weeks ago
Job Summary:
We are seeking a skilled HEDIS RN Specialist to join our team at Actalent. As a HEDIS RN Specialist, you will play a critical role in supporting our Quality Management team during the upcoming HEDIS season.
Key Responsibilities:
* Review and abstract 40-50 medical records per day based on NCQA and HEDIS technical specifications.
* Document information clearly and concisely from patient records into the HEDIS vendor's software application.
* Perform claims research, provider outreach, and create medical record requests.
* Ensure compliance with HEDIS audit and technical specification standards, as applicable to HEDIS reporting.
* Communicate with internal/external stakeholders by making appropriate follow-up phone calls for additional medical information needed to complete reviews.
Requirements:
* RN Compact License
* Bachelor's degree in Nursing
* Previous HEDIS experience
About Actalent:
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & Inclusion:
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
* Hiring diverse talent
* Maintaining an inclusive environment through persistent self-reflection
* Building a culture of care, engagement, and recognition with clear outcomes
* Ensuring growth opportunities for our people
Actalent is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, please email us for other accommodation options.
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