HEDIS RN - HYBRID

Summary We are seeking a dedicated and detail-oriented professional to contribute to Healthcare Effectiveness Data and Information Set (HEDIS) initiatives. This role is pivotal in ensuring the accuracy and compliance of clinical data for HEDIS reporting, regulatory submissions, and quality improvement projects. With a balanced schedule of in-office and remote work, you'll have the flexibility to thrive in a fast-paced environment. Responsibilities Review medical records to identify and validate clinical information relevant to HEDIS quality measures. Conduct clinical chart reviews, perform data abstraction, and ensure accurate documentation in designated systems. Identify gaps in clinical documentation and support follow-up efforts to obtain missing information. Navigate electronic medical records, provider records, and health plan systems to locate required clinical data. Support HEDIS data collection, quality measurement, and reporting deadlines. Coordinate with clinical quality teams, providers, and internal stakeholders as needed. Maintain compliance with HIPAA, member confidentiality requirements, and established quality standards. Meet productivity, accuracy, and turnaround-time expectations. Qualifications Registered Nurse (ASN or BSN required) - LPNs will not be considered. Minimum of 1 year of HEDIS review experience. Ability to work independently and effectively in a fast-paced, high-volume environment. Tech-savvy with proficiency in navigating multiple EMR systems such as E Clinical Works (ECW). Experience with HEDIS Measures such as BCS-E, COL-E, and EED is highly preferred. Skilled at maintaining discretion and confidentiality while handling sensitive information. #J-18808-Ljbffr Sierra Solutions