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Quality Management Nurse Consultant in Philadelphia, PA at Integrated Resources, Inc

Date Posted: 1/8/2019

Job Snapshot

Job Description

Duration:12-15 week(s)

Note: The majority of their work will be located in the Philadelphia or Moon Township office . However, the expectation is that they be willing to do whatever is asked of them to get the project completed, which could include travel. Mileage is reimbursed.

Job Description:
Licensed RNs, LPNs and LVNs will be considered. HEDIS Medical Record Review (HEDIS MRR) Abstractor HEDIS MRR PROJECT: The assignment will encompass HEDIS medical record review, including data collection from provider offices and abstraction of those records. HEDIS medical record review also consists of abstraction from electronic medical records and/or abstraction from faxed/mailed medical records. Training will be provided prior to the start of the assignment.

Duties Include:
  • Make and confirm site visit appointment prior to the date of appointment
  • Provide patient lists to provider offices
  • Locate and review all assigned medical charts, perform abstraction according to NCQA HEDIS specifications, and copy all chart documentation per Plan specifications
  • Complete the HEDIS Medical Record Review abstraction tool within live software environment
  • RN, LVN, or LPN licensed to work in the state of Pennsylvania with 3 years nursing experience
  • Knowledge of HEDIS MRR process is strongly preferred
  • Ability to read and interpret medical records
  • Professional demeanor and good work ethic
  • Conscientious problem solver, willing to learn, takes personal pride in their work performance/accuracy
  • Excellent verbal communication skills clear, concise and appropriate
  • Computer savvy: Microsoft Excel and Email preferred
  • Proven organizational and time management skills
  • Must have reliable transportation and willing and able to drive within their assigned geographic area (approximately 150 miles)
  • Must be able to lift 25 lbs
  • Must dress in business casual attire Critical Requirements:
  • Must commit to duration of the project cannot take another job elsewhere and abandon the assignment
  • Be flexible and work under pressure (awareness of and ability to meet deadlines)
  • Must keep all information collected in a safe, organized and confidential manner
  • Be able to work a minimum of 20 40 hours/week, Monday Friday
  • Candidate must commit to 3 full 8 hour training days.