AlliedTravelCareers is working with Cynet Health to find a qualified Technician in New York City, New York, 10004!
About The Position
Job Title : HEDIS Quality Reviewer Job Specialty : Quality Improvement Job Duration : 9 Months Shift : Day - 9am - 5pm, Hybrid Guaranteed Hours : 40 Hours / Week Experience : 3-5 years in Quality Improvement in a healthcare and / or Managed Care setting strongly preferred License : Not specified, but clinical background preferred Certifications : Clinical roles such as RN, LPN, LMSW, LCSW, or Foreign Medical Graduate preferred Must-Have : Proficiency in Microsoft Office applications (Word, Excel, PowerPoint, Access)- Knowledge of HEDIS and QARR specifications- Experience with EMR systems such as EPIC, Quadramed- Ability to travel within the service area- Knowledge of ICD-10 and CPT codes preferred Job Description : Maintain knowledge of medical record review and EMR systems.
- Stay updated on 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.
- Measure the effectiveness of quality improvement initiatives.- Identify, track, and report variations from standards of care by auditing core operations, patient care processes, and medical record documentation.
- Design interventions to drive improvement and minimize variation from standards of care.- Accurately and timely enter clinical quality findings in the appropriate system(s).
- Assist in implementing quality improvement activities as directed by Quality Management programming needs.- Support interdepartmental and internal teams focused on process improvement projects and outcomes.
- Provide educational support to physicians and staff to ensure process improvement and increase member satisfaction and retention.
- Facilitate retrieval of medical record documentation, working with provider groups and in-field navigators.- Record findings of patient encounters in a database, including patient identifiers, relevant information, and results.
- Participate in the annual HEDIS and QARR hybrid medical record review project, supporting temporary staff and serving as the final reviewer of records.
9399484EXPPLAT
Job Requirements
Required for Onboarding
- BLS - AHA
- Core Competency
- Pharmacology
- Skills Checklist
- Specialty Exam
About Cynet Health
Your travel adventure begins here. Matching talented healthcare heroes like you with high-paying jobs at the best facilities across all 50 states.
We offer the most competitive pay for every position we fill. We understand this is a partnership. You will have no surprises.
Your salary will be discussed upfront and there will be no troubling negotiation tactics.
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