Contract HEDIS Review Nurse career at Kelly Services in Houston

Kelly Services is hiring Contract HEDIS Review Nurse on Wed, 10 Apr 2013 12:59:01 GMT. Contract Hedis Nurse -Bellaire area Profile Summary: Perform medical chart review for HEDIS reporting for NCQA. Attention to detail and understanding of medical chart abstraction to capture undocumented medical services for HEDIS measures. Temporary assignment through mid-May, 2013- 40 hours per week and duties will be performed at Houston, Texas office. Responsibilities: Consults and works...

Contract HEDIS Review Nurse

Location: Houston Texas

Description: Kelly Services is hiring Contract HEDIS Review Nurse right now, this career will be placed in Texas. More details about this career opportunity please give attention to these descriptions. Contract Hedis Nurse -Bellaire area

Profile Summary:
Perform medical chart review for HEDIS reporting for NCQA. Attention to detail and understanding of medical chart abstraction to captur! e undocumented medical services for HEDIS measures. Temporary assignment through mid-May, 2013- 40 hours per week and duties will be performed at Houston, Texas office.

Responsibilities:
Consults and works closely with the HEDIS Team to review medical charts from HEDIS vendor or medical provider to capture undocumented medical services for HEDIS measures. Conduct medical record review MRR of HEDIS vendor as control check of their findings.
Communicates with HEDIS Team for follow up needs, with documentation in HEDIS tracking system. Facilitates provider contact as needed to obtain member s medical records. Contacts identified members to obtain approval for provider to release medical records. Conducts daily tracking of caseload as assigned Complies with all departmental policies and procedures.
Participates in departmental and company in-services as appropriate. Complies with Customer Service expectations as applicable to the Department. Assists ! in retroactive reviews done for the Claims department. Complie! s with all guidelines established by the Centers for Medicare and Medicaid CMS and guidelines set forth by other regulatory agencies, where applicable, and defined in the company's structure.

Required Experience:
LVN, with current state applicable licensure.
Two years utilization review or case/care management experience within a hospital, home health setting, outpatient clinic or managed care company Experience in physician office preferred .
Microsoft Word, Excel, PowerPoint and Outlook at the intermediate level at a minimum
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If you were eligible to this career, please email us your resume, with salary requirements and a resume to Kelly Services.

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This career starts available on: Wed, 10 Apr 2013 12:59:01 GMT

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