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Quality Management Nurse Associate 3
Ref No.: 18-26721
Location: Kenner, Louisiana
Description/Comment:Medical Record Review PROJECT: Position is seasonal assistance with annual HEDIS Medical Records Review Project. This position will be hired for the purposes of providing overreads for both compliant and non-compliant records. The assignment may also encompass medical record review, including data collection from provider offices and abstraction of those records. Medical record review also consists of abstraction from electronic medical records and/or abstraction from faxed/mailed medical records. Training will be provided prior to the start of the assignment.

Duties Include:
• Make and confirm site visit appointment prior to the date of appointment
• Provide patient lists to provider offices
• Locate and review all assigned medical charts, perform abstraction, and copy all chart documentation per Plan specifications
• Complete the Medical Record Review abstraction tool

Requirements:
• Licensed RN or LPN with 3-5 or more years of HEDIS field experience, previous overread experience preferred.
• Knowledge of medical record review process is strongly preferred
• Ability to read and interpret medical records
• Professional demeanor and good work ethic
• Conscientious problem solver, willing to learn, takes personal pride in their work performance/accuracy
• Excellent verbal communication skills – clear, concise and appropriate
• Computer savvy: Microsoft Excel, Outlook Email preferred, Windows, Excel
• Must have a printer and internet access
• Proven organizational and time management skills
• Must have reliable transportation and willing and able to drive within their assigned geographic area – position requires ability to travel within the state – seeking candidates residing in all areas of the state of Louisiana. Travel expectations will be minimal if any as providers submit most records to the plan via fax. Our project also has the support of Provider Relations team to secure records. Will consider potential candidates to work at home, outside of the state, must have 5+ years of HEDIS abstraction experience to be considered for this option in the overreader role.
• Must be able to lift 25 lbs.
• Must dress in business casual attire

Critical Requirements:
• Must commit to duration of the project – cannot take another job elsewhere and abandon the assignment
• Be flexible and work under pressure (awareness of and ability to meet deadlines)
• Must keep all information collected in a safe, organized and confidential manner
• Be able to work a minimum of 40 hours/week, Monday – Friday and overtime as project requires
• Candidate must commit to training