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in Des Moines, IA
HEDIS Quality Management Consultant RN
Hours | Full-time, Part-time |
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Location | Des Moines, Iowa 50309 Des Moines, Iowa |
About this job
Must Haves:
RN, LPN, or Medical background (CMA, medical records)
Register Nurse license preferred
2 or 4 year college degree with BSN preferred
Minimum 1+ year of experience within the health insurance, health care, clinical, managed care, or related setting.
Abstracts medical record data from practitioner's files to support annual Healthcare Effectiveness Data and Information Set (HEDIS) reporting for accredited products
Conducts medical record reviews to support the annual reporting and responds to inquiries from provider, and their office staff, regarding the HEDIS initiative
Review and abstract 30-40 medical records per day, based on NCQA and HEDIS technical specifications
Document information clearly and concisely from patient record to paper document abstraction tool, or intoelectronic HEDIS application
Participate in the training of NCQA (national committee quality assurance) requirements with completion of Inter-Rater Reliability compliance
Communicate with internal and external stakeholders by making appropriate follow-up phone calls for additional medical information to complete reviews
Comply with regulatory standards, accreditation standards and internal guidelines
Remain current and consistent with the standards pertinent to the Quality Management team
About Aerotek:
Our people are everything. As a Best of Staffing® Client and Talent leader, Aerotek® Inc. has distinguished itself as a leader in recruiting and staffing services, by having a deep understanding of the intersection of talent and business. As a strategic partner to more than 17,000 clients and 300,000 contract employees every year, Aerotek's people-focused approach yields competitive advantages for its clients and rewarding careers for its contract employees. Headquartered in Hanover, Md., Aerotek operates a network of over 230 non-franchised offices with more than 6,000 internal employees dedicated to serving our customers. Aerotek is an operating company of Allegis Group, a global talent solutions provider. To learn more, visit .
Aerotek is acting as an Employment Agency in relation to this vacancy.