US
0 suggestions are available, use up and down arrow to navigate them
PROCESSING APPLICATION
Hold tight! We’re comparing your resume to the job requirements…
ARE YOU SURE YOU WANT TO APPLY TO THIS JOB?
Based on your Resume, it doesn't look like you meet the requirements from the employer. You can still apply if you think you’re a fit.
Job Requirements of HCSC Quality Audit Specialist:
-
Employment Type:
Contractor
-
Location:
Nashville, TN (Onsite)
Do you meet the requirements for this job?
HCSC Quality Audit Specialist
Careers Integrated Resources Inc
Nashville, TN (Onsite)
Contractor
Job Title: HCSC Quality Audit Specialist
Job Location: Nashville, TN
Job Duration: 6-7 Months (possibility of extension)
Job Summary:
Job Location: Nashville, TN
Job Duration: 6-7 Months (possibility of extension)
Job Summary:
- Annually we report Healthcare Effectiveness Data and Information Set (HEDIS), this requires a medical record retrieval process and nurses are needed to conduct abstraction of medical records.
- Apply structured auditing criteria to abstract medical records, follow defined procedures for saving approved medical record documentation and accurately enter the results of chart audits into the healthplans database.
- Abstract medical record documentation submitted for HEDIS measures, used annually for reporting to National Committee for Quality Assurance (NCQA).
- The HEDIS measures are used to assist in measuring quality of health care provided to healthplan members.
- Maintains productivity level with less than a 5% error rate in record abstraction and data entry on an ongoing basis.
- Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
- Maintain complete confidentiality of company related business.
- Maintain effective communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
- Registered Nurse (RN) with unrestricted license in state.
- Licensed Practical Nurse.
- 5+ years relevant experience.
- Experience in utilization review, quality assurance, and/or medical record and site review audits.
- Knowledge of medical terminology standard medical practices, formal quality improvement process, and federal, state, accreditation regulations and standards.
- PC proficiency to include Word and Excel.
- HEDIS abstracting clinical information experience.
Get job alerts by email.
Sign up now!
Join Our Talent Network!