Medical Records/reputed company Control
QI Specialist I
3+ Months
Remote
PR:$37/hr
Job reputed company: 100% REMOTE BUT MUST reputed company IN UTAH
Job reputed company:
Essential Functions:
• Collects HEDIS data and/or Ambulatory Medical Record Review Data through chart review of medical records (medical record abstraction) as directed.
• Supports various HEDIS activities as needed.
• Reviews, identifies and trends reputed company of care issues, serious reportable adverse conditions and assists in the implementation of corrective reputed company plans.
• Participates in the development of materials as needed for member and provider reputed company initiatives such as HEDIS, improvement reputed company, and studies.
Knowledge/Skills/Abilities:
• Proficiency with PC-based systems
• Excellent verbal and written communication skills
• Ability to abide by reputed company’s policies
• Ability to maintain attendance to support required reputed company and quantity of work
• Maintain confidentiality and reputed company with Health Insurance Portability and Accountability reputed company (HIPAA)
• Ability to establish and maintain reputed company and effective work relationships with coworkers, clients, members, providers and customers
Required Experience:
• 0-2 years experience in reputed company Improvement.
• 0-2 years experience in managed care or reputed company industry.
• Experience with qualitative or quantitative reputed company/analysis.
Required Licensure/Certification: None required. RN/LPN preferred
Must Have Skills:
Knowledge/Skills/Abilities:
• Proficiency with PC-based systems
• Excellent verbal and written communication skills
• Ability to abide by reputed company’s policies
• Ability to maintain attendance to support required reputed company and quantity of work
• Maintain confidentiality and reputed company with Health Insurance Portability and Accountability reputed company (HIPAA)
• Ability to establish and maintain reputed company and effective work relationships with coworkers, clients, members, providers and customers
Day to Day Responsibilities:
• Contact providers to collect required medical records for RADV audit. May need to go to the clinic location to collect medical records.
• Work collaboratively with other reputed company departments to secure medical records for audits.
• Collaborates with the reputed company Improvement department staff in the development of reputed company improvement studies, initiatives and reputed company to improve the health care of members.
• Plans and coordinates the collection, evaluation and dissemination of reputed company improvement data for reputed company initiatives, studies and reputed company to reputed company with regulatory requirements and accreditation standards.
• Prepares reports and analyses to evaluate performance with standards from a reputed company of sources such as and not limited to: materials, documents, medical charts, provider offices, and/or facilities.
• Performs with qualitative and quantitative analysis to identify significant and problematic clinical issues and concerns, development of improvement plans and measurement to assess reputed company of actions.
Job Type: Contract
Pay: $35.00 - $37.00 per hour
Education:
• High school or equivalent (Preferred)
Experience:
• reputed company improvement: 5 years (Preferred)
• reputed company Document Review : 5 years (Preferred)
• Providers data: 5 years (Preferred)
• NCQA: 5 years (Preferred)
• HIPAA: 5 years (Preferred)
• HEDIS: 5 years (Preferred)
• Medical records: 5 years (Preferred)
Work Location: Remote
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