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Employee Health Nurse Jobs in Columbia, MD

Medical Review Nurse (HEDIS)

Cynet Systems

  • Columbia, MD
  • 3 days ago
  • $36–$41.49 Per Hour
  • Contractor

Highlights

The role involves using proprietary tools and software to conduct medical record reviews, coordinating with healthcare provider offices to obtain records and verify contact information, following up on retrieval requests, and escalating issues as needed. The Clinical Medical Review Specialist supports HEDIS quality initiatives by retrieving, reviewing, and accurately abstracting medical records in accordance with NCQA specifications.

Numbers & Facts

LocationColumbia, MD
Job TypeContractor
Salary$36–$41.49 Per Hour

Description

  • The Clinical Medical Review Specialist supports HEDIS quality initiatives by retrieving, reviewing, and accurately abstracting medical records in accordance with NCQA specifications.
  • The role involves using proprietary tools and software to conduct medical record reviews, coordinating with healthcare provider offices to obtain records and verify contact information, following up on retrieval requests, and escalating issues as needed.
  • The specialist must maintain strict compliance with HIPAA privacy and security standards while supporting the Quality Team in medical record retrieval and review activities.

Qualifications

  • Clinical experience with knowledge of HEDIS measures and medical record review practices.
  • Understanding of NCQA specifications and HEDIS quality measures.
  • Experience with medical record retrieval, chart review, and clinical data abstraction preferred.
  • Knowledge of HIPAA privacy and security requirements.
  • Proficiency in Microsoft Excel, Word, PowerPoint, and web-based applications.
  • Strong organizational skills, attention to detail, and the ability to prioritize multiple tasks.
  • Excellent written and verbal communication skills.
  • Strong interpersonal and problem-solving skills.
  • Ability to work independently and collaboratively within a team.
  • Experience contacting provider offices and coordinating medical record requests.
  • Ability to use clinical software, electronic medical records (EMR), and medical record retrieval tools.

Skills

  • HEDIS
  • Medical Record Review
  • Clinical Data Abstraction
  • NCQA standards
  • Medical Record Retrieval
  • HIPAA compliance

Benefits

Paid Time-Off, Life Insurance, 401K, Medical, Dental, Vision

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