Healthcare Consultant II (HEDIS)

Job Title: Healthcare Consultant II (HEDIS)
Location: Remote, RI 02895
Duration: 4 Months+ Contract (Possibilities of Extension)

Pay Rate: $31.80/hr. on W2

Position Summary:
Participates in the audit/overread of the medical record collection and review process for HEDIS quality reporting. Training will be provided prior to the start of the assignment.
This position audits and interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and audits data populated within a data collection tool to support compliance with HEDIS and CMS performance measures. Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements. The candidate must be proficient with databases and with conducting 100% of work activities on the computer.
 
Additional Notes:

• I AM NOT YET SURE HOW MANY WILL BE PRE-IDS. I WOULD SUGGEST STARTING BY SUBMITTING ANY CONTRACTORS THAT WORKED HEDIS LAST YEAR BEFORE YOU PUT ANYONE ELSE.
• SO LONG AS THE INDIVIDUAL WAS NOT LET GO FOR NEGATIVE REASONS - THEY MAY HAVE A GREATER CHANCE OF HIRE.
• IF ANY CONTRACTORS HAVE REACHED OUT STATING THEY WERE TOLD THEYRE COMING BACK, TRY TO ALIGN THIM WITH THE REQ THAT FITS THEIR PREVIOUS ROLE.
• This posting will have some pre-id candidates. We'll request candidates to hire any difference.
• REMINDER: Please have the temp candidate take a drug test as soon as the 30 day window hits.

 
Candidate Questionnaire (Please return completed with resume):

• Is the name listed on your resume your legal name and spelt correctly? If not, please provide that name.
• What is your current address (including the Apartment unit # and info if applicable)? Suppliers, make sure this matches in Fieldglass.
• Do you have an alternate phone number to what is already on your resume?
• Are you able to work Monday thru Friday, 8 am to 5 pm your local time (January thru May) without interruption?
• Do you have anything that requires time off or would prevent you from working the above required schedule (January thru May)?
• Please list 3 different Microsoft Office Suite Programs you have experience with and how many years you've worked in each one.
• Are you able to connect the Healthcare provided laptop to your home internet modem via an ethernet cable connection? (Not thru a WiFi connection.)

 
Duties:

• Auditing of information entered into the software system for abstraction and data entry based on HEDIS MY 2020 Technical Specifications.
• Prioritize and accurately complete tasks within established times.
• Identifying trends and documentation of areas for improvement.
• Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities.

 
Experience:

• 5 or more seasons of HEDIS experience in reviewing medical records is required.
• Prior experience in performing chart audits is preferred.
• Candidate must commit to attend all required training and conference calls assigned for the project.
• Candidate must return all equipment that is supplied to them in good working condition and in a timely manner at the end of the project.
• Medical knowledge/terminology is required.
• Ability to read and interpret medical records.
• Professional demeanor and good work ethic.
• Computer savvy: Microsoft Word, Excel, email, and Adobe reader required. Know how to save a file to a folder.
• Excellent verbal and written communication skills – clear, concise and appropriate.
• Conscientious problem solver, willing to learn, and take personal pride in their work performance/accuracy.
• Exceptional attention to detail and excellent analytical, investigation, and problem-solving skills.
• Proven organizational and time management skills including the ability to meet required deadlines.
• Must keep all information collected in a safe, organized and confidential manner while maintaining confidentiality of PHI, HIPAA Privacy and Security Rules.

 
Education:

• RN/LVN with an associate or bachelor degree is preferred but not required.
• Successful HEDIS review experience may be substituted for licensure.