Healthcare Consultant II

2 days ago

Providence, Rhode Island, United States Integrated Resources Full time
Job Summary

We are seeking a skilled Healthcare Consultant II to join our team at Integrated Resources. As a key member of our team, you will play a critical role in ensuring the accuracy and completeness of medical records for HEDIS quality reporting.

Key Responsibilities
  • Audit and interpret relevant clinical criteria through review of medical records
  • Annotate via Adobe PDF and audit data populated within a data collection tool
  • Ensure accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements
  • Prioritize and accurately complete tasks within established times
  • Identify trends and document areas for improvement
  • Maintain project productivity levels while maintaining accuracy requirements for abstraction and data entry activities
Requirements
  • 5 or more seasons of HEDIS experience in reviewing medical records
  • Prior experience in performing chart audits is preferred
  • Ability to read and interpret medical records
  • Professional demeanor and good work ethic
  • Computer savvy: Microsoft Word, Excel, email, and Adobe reader required
  • Excellent verbal and written communication skills
  • Conscientious problem solver, willing to learn, and take personal pride in their work performance/accuracy
  • Exceptional attention to detail and excellent analytical, investigation, and problem-solving skills
  • Proven organizational and time management skills including the ability to meet required deadlines
Education

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

This is a fully remote position, and the candidate must be able to work Monday through Friday, 8 hours a day, between 8am and 5pm local time. Onsite requirements are not applicable.

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