Clinical Review HEDIS RN - New York - New York, New York - NurseRecruiter.com

Per Diem Nursing Job in
New York , New York

  • Employer: CGC Group Inc
  • Profession: Registered Nurse
  • Specialty: Medical Surgical

Inquire about this Job

Share This Job
THIS IS A REMOTE POSITION, MUST BE LICENSED FOR NY, POSITION IS FROM OCTOBER 2020 - MAY 2021

The primary function of the Clinical Quality HEDIS RN is to assess and audit medical record charts for ensuring compliance with EmblemHealth, regulatory and accreditation requirements, e.g., collection of Healthcare Effectiveness Data and Information Set (HEDIS) and Quality Assurance Reporting Requirements (QARR) audits, Internal Peer Review Organization and Department of Health audit activities. The information abstracted from completed chart review will directly impact EmblemHealth’s Quality award programs, including Medicare Stars and Quality Incentive Awards.


Principal Accountabilities

Support Emblem Health’ s Quality program by conducting targeted chart review with the sole purpose of enhancing quality scores during the annual Medical Record Review project as well as throughout the year for Supplemental data collection.
Schedule appointments with providers and staff and ensure timely completion of duties to meet internal, regulatory and accreditation standards and requirements.
Conduct targeted medical record review audits for specified provider groups to ensure members are receiving appropriate medical care, identify areas for provider education, academic detailing, and assess for trends in records reviewed. Audits will be conducted, summarized and reported back to corresponding product team or delivery system work group to act on identified issues.

Education, Training, Licenses, Certifications

• Knowledge of HEDIS/QARR/Star specifications required
• Current licensed NP, LPN or RN with 3-5years of clinical experience in critical care or med-surgical experience required.

Job Requirements

HEDIS & QARR ,LPN or RN

Location

New York, New York

Employment Type

Per Diem

Employer

CGC Group Inc

Date Posted

Oct 23rd, 2020

Not what you're looking for? No problem! Register now to gain access to our entire job board.

Featured

Find More Jobs