HEDIS Reviewer III will serve as a SME for the HEDIS MY2024 Audit. The nurse SME will attend training provided by thec client on required data needed to meet compliance for specific Hybrid HEDIS measures. Responsibilities will include providing training to nurse reviewers on measure abstraction; Over-reading 100% of data entered compliant chases for accuracy; managing all aspects of assigned measure. Candidates must have 3+ years of HEDIS record abstraction experience, proven organizational and time management skills, experience in a work-from-home scenario, and excellent verbal communication skills – clear, concise, and professional. Position requires flexibility and the ability to work under pressure to meet hard deadlines. Ideal candidate will have experience in training. Qualified candidates will possess a professional demeanor and have a strong work ethic, be self-motivated, a conscientious problem solver, willing to learn, and take personal pride in their work performance/accuracy. Must be computer savvy with working knowledge of Microsoft Excel, Outlook, and Adobe preferred. Candidate must be able to commit to duration of the project.Duties-Train staff on assigned Hybrid measure-Over-read all chases for assigned measure, both compliant and non-compliant entries-Review, abstract and data enter medical record data obtained via paper, electronic, CD, fax or mail-Name and file medical record documents electronically, maintaining member PHI and PII-Fax medical record requests to provider offices if requested-Provide patient lists to provider offices-Accurately enter data into Electronic Medical Record Review abstraction tool-Communicate daily with abstraction review nurses regarding errors or changes in daily expectations-Perform outreach calls as needed to provider offices to obtain medical recordsExperienceCandidates must have 3+ years of HEDIS record abstraction experience, proven organizational and time management skills, experience in a work-from-home scenario, and excellent verbal communication skills – clear, concise, and professional.EducationBSN PreferredActive and good standing RN licensePosition requires advanced degree and licensing. BSN preferredRN active and in good standing License required. the license is required, the type can be RN (preferred) or LPN (would need great experience).Mon-Fri; 7:30 - 4pm; Arizona time zone (MST)Fully remote (never coming onsite)Licensed RN (Note: license must be good in Arizona state)VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
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