Quality Medical Record Review ( HEDIS and RN)

Job Title: Quality Medical Record Review ( HEDIS and RN)

Time: 8am-5-pm CST...

Location: Remote

Pay: $40

Start:1/22/2025

End: 5/22/2025

Job Description:

The Healthcare Effectiveness Data and information Set (HEDIS) Quality Assurance Nurse Overreader works under the direction of the HEDIS Quality Assurance Team Lead and other Cigna personnel to perform quality assurance reviews on medical records.

The HEDIS Quality Assurance Nurse Reviewer will validate abstracted medical record data and enter findings electronically into a specified data base to support HEDIS Reporting and Quality Improvement.

The candidate may be required to perform other duties toward HEDIS collection as assigned including HEDIS medical record review and outreach for collection of medical records.

This is a fast-paced environment and candidates must adhere to measured productivity and accuracy requirements.

The candidate is required to attain a score of 100% on specific measure testing prior to conducting live medical record reviews and overreads.

Candidate must also be able to achieve and maintain a quality reliability score of 95% or higher to remain eligible for employment for the duration of the project.

Required Skill

Follow established procedures for conducting Quality Assurance Overread reviews of abstracted medical records

Extract electronic medical record data using multiple systems

Enter pertinent data from paper and electronic medical records into database as required by established quality assurance abstraction procedures

Communicates effectively and professionally

Meet or exceed productivity and accuracy requirements

Ability to work independently and in team environment

Excellent time management and prioritization skills

Excellent communication skills (written and verbal)

Strong attention to detail

Ability to multi-task

Flexibility with assignment change

Highly organized

Evidence of strong computer skills including the Microsoft office suite (e.g., Microsoft Outlook, Excel, and Word)

Maintain patient confidentiality by protecting patient information from unauthorized disclosure

Other duties as assigned

Education:

RN or LPN/LVN license.

3-5 years recent HEDIS medical record review experience preferred

Quality improvement or medical record review experience preferred

Computer experience (i.e., Excel, Word, Outlook) required
? *ALL POSITIONS ARE REMOTE***

Must have reliable internet connection and experience working in a remote setting

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