HEDIS Medical Review Nurse - LPN (100% Remote)
Information Technology company
Information Technology company
Jacksonville, FL 32256
W-2 onlyUS ResidentContract3083 views
Jacksonville, FL 32256
Contract
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Seeking a HEDIS Medical Review Nurse - LPN for a 100% Remote position. Must be licensed in Florida.

This position is for the annual HEDIS Review.

Description

  • Perform medical record reviews to support improvement and compliance, abstract HEDIS data, to include over-read of reviews, working collaboratively with the internal HEDIS STARs Team and the Quality Team.
  • Perform administrative functions to include; medical record requests, faxing, and calls to members and providers as needed. Maintain organized, updated reporting of activities with clear documentation.
  • Required to track, monitor, and report on the status of records and volume of work.
  • Complete claim research to identify the service performed, dates of service, provider type, and place of service. Research may include multiple systems and reports.

Requirements

  • Active LPN license with two (2) years of related work experience
  • Must have previous medical record/quality review experience; HEDIS/STARS
  • Must be proficient in Microsoft Office (Word, Excel, Outlook, and PowerPoint) as well as Internet research skills
  • Ability to communicate clearly verbally and in writing
  • Organizational skills are very important; must be able to work independently to complete tasks with minimal direction.
  • Disease management experience is nice to have.
  • Recent experience in medical record reviews, data collection for HEDIS / Stars.

Skills
Skill Proficiency Years Experience Percent Used
HEDIS
1 - 3100%
LPN
Any100%
Nursing
1 - 375%
Medical Records
1 - 350%