About this role
HEDIS LVN/LPN
We are seeking Licensed Practical Nurses (LPNs) to support a healthcare quality initiative focused on HEDIS, medical record review, and quality reporting. This is a temporary position that will primarily involve reviewing medical records and clinical documentation, identifying relevant information needed for quality measures, and supporting accurate and timely reporting.
This is a great opportunity for LPN/LVNs with experience in a medical office, clinic, hospital, health plan, medical records, care management, or healthcare quality environment. Candidates should be comfortable reviewing clinical documentation, working with electronic medical records, and communicating with healthcare providers and medical offices as needed.
Essential Job Functions:
- Data mine remotely directly from EHR systems to close quality gaps in care.
- Outreach to provider offices to request medical record data.
- Act as a SME for data collection and HEDIS questions, asked by provider offices.
- Review and abstract medical record data into appropriate application(s).
- Follow up to offices that have failed to comply with a records request or have sent incomplete chart documentation.
- Analyze chart data, evaluate for possible data integrity and/or data deficits and document findings.
- Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures.
- Support hybrid chart chase processes by requesting records from provider offices as needed.
- Maintain education/knowledgebase of HEDIS/STARs standards and guidelines.
- Perform all other related duties as assigned.
Minimum Required Education, Experience & Skills:
- Licensed Professional/Vocational Nurse
- One or more years provider outreach
- One or more years HEDIS/STAR experience
- Two or more years of experience with data analysis/quality chart reviews. Must be able to review medical records and assess completeness.
- Excellent communication practices, both oral and written.
- Experience using Microsoft Office applications, including databases, word-processing, and Excel spreadsheets.