The Judge Group Hiring for Hedis Quality Reviewer at New York, NY Full Time

Duties:

• Maintain knowledge of medical record review and EMR systems.
• Maintain up-to-date knowledge of HEDIS, QARR and Star specifications
• Distribute requests for records and schedules appointments with provider offices to ensure timely completion of duties to meet internal and regulatory standards and requirements.
• Perform clinical audits via EMR, in-house paper medical records, on-site provider visits to measure compliance with preventive health guidelines and to measure effectiveness of quality improvement initiatives.
• Identify, track and variation from standards of care by audit of core operations, patient care processes and medical record documentation. Designs interventions to drive improvement and minimize variation from standards of care.

Skills:

• Clinical background: Health Educator, RN, LPN, RN, LMSW or LCSW, Foreign Medical Graduate (FMG) with a minimum of three years relevant work experience.
• Experience with medical record review working on HEDIS/QARR in a managed care or health plan setting.
• 3 – 5 years in Quality Improvement in a health care and/or Managed Care setting strongly preferred.
• Ability to travel within the Metro Plus service area.
• Knowledge of HEDIS and QARR specifications.
• Experience using EMR systems, e.g. EPIC, Quadra med.
• Proficient in Microsoft Office applications including Word, Excel, PowerPoint and Access.

Shift Time: 9:00am- 5:00pm

Job Types: Full-time, Contract

Salary: $31.85 – $36.00 per hour

Schedule:

• Day shift

Ability to commute/relocate:

• Metroplus Health Plan – 50 Water Street New York, NY 10004: Reliably commute or planning to relocate before starting work (Required)

Experience:

• HEDIS: 2 years (Required)
• managed care: 1 year (Required)
• HEDIS and QARR: 1 year (Required)
• EPIC: 1 year (Required)

Work Location: In person