HEDIS Review Nurse at Cotiviti

Remote | Part-time
Cotiviti

HEDIS Review Nurse (Remote/Nationwide)

Clinical Operations HEDIS03216

  • Part-Time
  • Nationwide (Remote)

Description

The HEDIS Abstractor will function as support of the HEDIS Team during the traditional HEDIS season and/or during off-season projects. THE HEDIS Abstractor will perform at minimum abstraction of assigned measures, QA, and training as part of their responsibilities.

Responsibilities:

  • Works in conjunction with HEDIS Team Leads and/or HEDIS Management to complete training and subsequent abstraction by measure specific team assignment.
  • Abstraction includes medical record review of specific measure criteria and entering findings into abstraction tool. Medical records could either be part of an electronic medical record (EMR) or digital records (i.e. PDF).
  • Works with HEDIS Team Leads and/or Management to perform QA review that is either ad hoc or scheduled.
  • Will escalate matters to HEDIS Team Leads or HEDIS Manager as appropriate.
  • Collaborates with other HEDIS Abstractors and will always demonstrate Cotiviti core values.
  • Will adhere to compliance of the remote policy, HIPAA regulations, professional conduct and ethical practice.
  • Completes all special projects and other duties as assigned.
  • Must be able to perform duties with or without reasonable accommodation.

Requirements:

  • Registered Nurse (LPN not accepted) with active unrestricted license in state of residence or Certified Medical Coder. RN’s must have a minimum one (1) year clinical experience.
  • Minimum of 2 years of experience with NCQA HEDIS Hybrid measure abstraction and QA.
  • Experience working with HEDIS data entry software and reporting tools
  • Experience working remotely on team projects
  • Must be comfortable communicating via various modes (email, IM, phone) in a timely manner.
  • Must be comfortable using/learning Microsoft Office products (Outlook. Teams, Word, Excel, etc.)
  • Ability to establish and maintain positive and effective work relationships with coworkers, clients and management
  • Strong data entry and computer navigation skills
  • Detail and process oriented with focus on efficiency

Work Environment:

  • This is an at home-based position and you must have a work location within the continental US
  • This position requires that you provide a high speed internet connection and a work environment free from distractions
  • Must be able to start work in late January or the first part of February and work through May.
  • Must be able to work at minimum 20 hours per week.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.

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