Job Description

SLOTS FULL, please Pipeline! ATTENTION: in need of 6 contingent remote workers in the US for HEDIS until Dec 2025 for pursuit and abstraction.

SHIFT: M-F 8-5 CST, NO OT

Duration: 6 months Job Description: Position Purpose: Lead data collection and abstraction for company quality measures, including HEDIS, CMS, CHIPRA and/or any other custom measurements. Education/Experience: Associate's degree in related field or equivalent experience. Bachelor degree preferred. 4+ years of nursing, medical assistant, medical coding or data management experience. Experience in quality initiatives (including HEDIS project, study analysis, or NCQA standards) preferred. Advanced knowledge of Microsoft Applications, including Excel and Access. Licenses/Certifications: Current state's RN or LPN license preferred. Responsibilities: Heavily focused on abstraction. Responsible for collecting medical records by looking through claims and outreaching to providers, handling pends from Vendors, Pulling charts from EMRs. 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.

Candidate Requirements Required: 2 or 4 year degree Preferred: Required: LPN, RN or 5 years abstraction Preferred: Axelon

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