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Hedis Nurse- RN Required- 100% Remote

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Actalent

1mo ago

  • Job
    Full-time
    Mid & Senior Level
  • Research & Development
    Healthcare
  • Dallas

AI generated summary

  • You need an RN license, HEDIS experience, strong analytical and communication skills, healthcare data proficiency, attention to detail, a BS in Nursing, and HEDIS or quality improvement certification.
  • You will review medical records, abstract data for HEDIS standards, track issues, communicate outcomes with health plans, and support quality initiatives.

Requirements

  • Registered Nurse (RN) license.
  • Experience with HEDIS measures and data abstraction.
  • Strong analytical and problem-solving skills.
  • Excellent communication and interpersonal skills.
  • Proficiency in healthcare data systems and software.
  • Ability to work independently and as part of a team.
  • Attention to detail and strong organizational skills.
  • Bachelor’s degree in Nursing or related field.
  • Certification in HEDIS or healthcare quality improvement.
  • Experience in healthcare quality improvement or clinical auditing.

Responsibilities

  • Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards
  • Review medical records and abstract data for HEDIS and other measure sets in compliance with standards
  • Track and report on issues and outcomes related to abstractions and over-reads
  • Communicate outcomes of abstraction and over-sight activities with health plans and vendors when required
  • Perform other quality initiatives as necessary

FAQs

Do we support remote work?

Yes, this position is 100% remote.

What are the primary responsibilities of the HEDIS Nurse?

The HEDIS Nurse will manage all aspects of the HEDIS process, including data collection, verification, abstraction of medical records, and report generation.

What qualifications are required for this position?

A Registered Nurse (RN) license is required, along with experience with HEDIS measures and data abstraction, strong analytical skills, and excellent communication abilities.

Is a specific degree required for this role?

A Bachelor’s degree in Nursing or a related field is preferred but not mandatory.

Are there any certifications that would be beneficial for this position?

Yes, certification in HEDIS or healthcare quality improvement is preferred.

What skills are emphasized for this role?

Strong analytical and problem-solving skills, attention to detail, organizational skills, and proficiency in healthcare data systems and software are essential.

Does the company have any diversity and inclusion initiatives?

Yes, Actalent emphasizes diversity, equity, and inclusion as integral parts of its culture, focusing on hiring diverse talent and maintaining an inclusive environment.

How does one apply for this position?

Interested applicants can apply through the Actalent website or the job posting platform where this job is listed.

Is prior healthcare quality improvement experience necessary for this role?

While it is not required, experience in healthcare quality improvement or clinical auditing is preferred.

What type of work environment can I expect in this role?

This role allows for independent work while also being part of a collaborative team focused on achieving healthcare quality and compliance standards.

An Engineering and Sciences Services Company | People to Possible

Human Resources
Industry
5001-10,000
Employees

Mission & Purpose

Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the globe are making an impact. We’re supporting critical initiatives in engineering and sciences that advance how companies serve the world. Actalent’s global footprint and flexible delivery models ensure access to specialized talent where and when you need it. We promote consultant engagement through professional development and provide experiences to ensure continuous learning. Our people are the difference. Our expertise spans capabilities in engineering including product and manufacturing, systems and software, construction management, environmental, architecture and civil; and power and utilities. We focus on sciences capabilities in laboratory sciences, healthcare, and clinical research. Actalent is an operating company of Allegis Group, the global leader in talent solutions.