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Medical Review Nurse - HEDIS (558656)
Ref No.: 17-09271
Location: Jacksonville, Florida
Position Type:Contract
Start Date / End Date: 11/27/2017 to 05/10/2018
Description:
Determine member compliance via medical record review according to the NCQA technical specifications. Communicate with provider, internal customers and external vendors. Position will include some administrative tasks including but not limited to; faxing and populating spreadsheets. Required to track, monitor and report on the status of records and volume of work.

Requirements:
Requirements:
Active Florida Nursing License
Must have previous quality review experience; HEDIS preferred
Must be Proficient in Microsoft Word and Excel
Excellent communication skills
Successful completion of Excel test (include test results on resume)
Organizational skills are very important ; must be able to work independently to complete tasks with minimal direction.
Preferred:
AAAHC, Joint Commission, or Magnet experience is helpful
Disease management experience is helpful
Recent experience in data collection for HEDIS / Stars