Description

We are seeking a HEDIS Quality LPN/RN to join a fully remote team. The HEDIS Quality LPN/RN focuses on HEDIS operations and data collection. The HEDIS Quality LPN/RN position offers a short-term contract employment opportunity.

Responsibilities:

• Assist in medical records review to identify Star/HEDIS opportunities for the medical staff.

• Perform data collection and data entry tasks to close gaps in care.

• Collaborate with the leadership and clinical staff to identify trends and potential strategies to support the practice.

• Communicate any challenges or trends that may negatively impact quality outcomes.

• Track and trend barriers or challenges at assigned groups for better outcomes, including appointment access, follow-up on referrals, or inconsistent coding practices.

• Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures.

• Support quality initiatives by requesting medical records from providers' offices as needed.

• Respond to incoming Clinical Quality inquiries from all communication avenues such as phone, fax queue, TruCare, or department email box.

• Conduct in-bound and out-bound calls for quality requirements including medical records requests and contact verification.

• Provide clerical and/or administrative support to quality staff and managers for special projects and reporting needs.

• Deliver excellent customer service by serving as a resource to all internal and external customers.

• Maintain education and knowledge base of HEDIS/STARs.

• Perform datamining tasks.

Requirements

·      Licensed Practical Nurse

·      Minimum 2 year HEDIS experience and/or knowledge

·      Solid knowledge of managed care requirements related to clinical quality

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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