Clinical Nurse Specialist

1 day ago


Baltimore, Maryland, United States Charter Global Full time
Job Title: Clinical Nurse Specialist

We are seeking a highly skilled Clinical Nurse Specialist to join our team at Charter Global. The successful candidate will have a strong background in clinical nursing and experience in HEDIS overreads.

Job Summary:

The Clinical Nurse Specialist will be responsible for conducting thorough HEDIS overreads in line with NCQA guidelines. This will involve accurately and efficiently over-reading medical record abstractions performed by the HEDIS abstraction staff on a daily basis.

Key Responsibilities:
  • Conduct HEDIS overreads in line with NCQA guidelines
  • Accurately and efficiently over-read medical record abstractions
  • Correct errors identified through over-read process
  • Identify and report abstraction errors
  • Provide measure re-education with the abstractor
  • Utilize various software applications to support HEDIS operations
  • Maintain productivity level as determined by the QI Department
  • Maintain compliance with all HIPPA and member confidentiality requirements
Requirements:
  • Must be a RN or LPN with HEDIS experience
  • At least 5 years of experience with HEDIS, specifically HEDIS overreads
  • 6 years of overall experience with nursing, including clinical back-side nursing and quality
  • Bachelors degree in Nursing, Associates Degree in Nursing, or Diploma in Nursing
What We Offer:

We offer a competitive salary and a dynamic work environment. If you are a motivated and experienced Clinical Nurse Specialist, we encourage you to apply for this exciting opportunity.



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