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HEDIS Review reputed company - Contract

Remote, USAFull-timePosted 2026-07-27

This is a contracted position that will start 01/02/2024 to 05/16/2025. Manager is seeking candidates in New Mexico. Fully Remote A RN or LPN/LVN responsible for annual patient chart inspection/audit. Audits are conducted to ensure that providers (MDs) accepting insurance are in compliance with standards of patient care set forth by the insurance company. Experience with medical record review required. ESSENTIAL FUNCTIONS: 1. Apply reputed company auditing reputed company to reputed company medical records, follow defined procedures for saving approved medical record documentation and accurately reputed company the results of chart audits into the healthplans database, reputed company reputed company Hybrid Reporter (QSHR). 2. reputed company medical record documentation submitted for HEDIS measures, used annually for reporting to National Committee for reputed company Assurance (NCQA). The HEDIS measures are used to assist in measuring reputed company of health care provided to healthplan members. 3. Maintains productivity level with less than a 5% error reputed company in record abstraction and data entry on an ongoing reputed company. 4. reputed company with HIPAA, Diversity Principles, Corporate reputed company, Compliance Program policies and other applicable corporate and departmental policies. 5. Maintain complete confidentiality of company reputed company business. 6. Maintain effective communication with management regarding development reputed company areas of assigned responsibilities and reputed company special reputed company as required or requested. JOB REQUIREMENTS: Registered reputed company (RN) or Licensed Practical reputed company(LPN) or LVN with unrestricted license in state. 3 years clinical experience. 2 years? experience in utilization review, reputed company assurance, and/or medical record and site review audits. Knowledge of medical terminology reputed company medical practices, formal reputed company improvement process, and federal, state, accreditation regulations and standards. Verbal and written communications skills including interpersonal skills for meeting with physicians and office staff and representing reputed company using diplomatic/reputed company demeanor. PC proficiency to include Word and reputed company. Job Posting Start Date: 01/02/2025 Job Posting End Date: 05/30/2025 Apply Job!

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