HEDIS Specialist

divh2HEDIS Specialist/h2pIntegrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow./ph3Job Description/h3pUnder the direction of the HEDIS Program Manager, supports the annual HEDIS project management by coordinating the identification, collection and abstraction of medical records and other data in collaboration with other HEDIS staff./ppEssential Functions:/pulliAssists the Manager in the coordination and preparation of the HEDIS medical record review which includes ongoing review of records submitted by providers and the annual HEDIS medical record review./liliParticipates in meetings with vendors for the medical record collection process./liliAssists Manager with medical record vendor oversight./liliAssists Manager in training abstractor staff and participates in the medical record IRR./liliIdentifies member service gaps based on data loaded in the HEDIS application./liliCollects medical records and reports from provider offices based on member needed services reports and gaps and loads data into the HEDIS application./liliWorks with the corporate HEDIS team to monitor accuracy of abstracted records as required by HEDIS specifications./liliParticipates in scheduled meetings with the corporate HEDIS team, vendors and HEDIS auditors./liliAssists the QI staff with physician and member interventions and incentive efforts as needed./liliProvides data collection and report development support for Quality Improvement studies and performance improvement projects./liliAssists as needed in support of accreditation activities such as NCQA reviews, CAHPS and state audits./li/ulpKnowledge/Skills/Abilities:/pulliProficient with PC-based systems and the ability to learn new information systems and software programs./liliAbility to work with large files and data sets./liliBasic understanding of Health Plan billing practices and information systems./liliStrong communication and teaming/interpersonal skills; strong leadership capabilities./liliAbility to initiate and maintain cross-team relationships./liliExcellent verbal and written communication skills./liliAbility to abide by policies./liliMaintain regular attendance based on agreed-upon schedule./liliMaintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)./li/ulh3Qualifications/h3ulliState Licensed Vocational Nurse or Registered Health Information Technician (RHIT), or Certified Medical Record Technician with training in coding procedures./li/ulpRequired Experience:/pulli5+ years coding and medical record abstraction experience./lili5+ years managed care experience./liliBasic knowledge of HEDIS and NCQA./li/ulpRequired Licensure/Certification :/pulliLicensed LVN/LPN, Registered Health Information Technician (RHIT), or Certified Medical Record Technicians./li/ulh3Additional Information/h3pKind Regards,/ppKavita Kumari/ppClinical Recruiter/ppIntegrated Resources, Inc./ppIT Life Sciences Allied Healthcare CRO/ppDIRECT # - View phone number on click.appcast.io/p/div