What are the responsibilities and job description for the Quality Clinical Management Senior Analyst(Overread) position at Integrated Resources, Inc ( IRI )?
1/2 day of onboarding shift start time- 10am CST
Shift Start and End Times- 8am-5-pm
Job Description
Job Title Job Description Required Skills Education/Experience
Quality Assurance Nurse Reviewer (Overread Team) The Healthcare Effectiveness Data and information Set (HEDIS) Quality Assurance Nurse Overreader works under the direction of the HEDIS Quality Assurance Team Lead and other Client personnel to perform quality assurance reviews on medical records. The HEDIS Quality Assurance Nurse Reviewer will validate abstracted medical record data and enter findings electronically into a specified data base to support HEDIS Reporting and Quality Improvement. The candidate may be required to perform other duties toward HEDIS collection as assigned including HEDIS medical record review and outreach for collection of medical records. This is a fast-paced environment and candidates must adhere to measured productivity and accuracy requirements. The candidate is required to attain a score of 100% on specific measure testing prior to conducting live medical record reviews and overreads. Candidate must also be able to achieve and maintain a quality reliability score of 95% or higher to remain eligible for employment for the duration of the project.
3-5 Years Recent HEDIS Medical Record Review Experience Preferred
Quality improvement or medical record review experience preferred
Shift Start and End Times- 8am-5-pm
Job Description
Job Title Job Description Required Skills Education/Experience
Quality Assurance Nurse Reviewer (Overread Team) The Healthcare Effectiveness Data and information Set (HEDIS) Quality Assurance Nurse Overreader works under the direction of the HEDIS Quality Assurance Team Lead and other Client personnel to perform quality assurance reviews on medical records. The HEDIS Quality Assurance Nurse Reviewer will validate abstracted medical record data and enter findings electronically into a specified data base to support HEDIS Reporting and Quality Improvement. The candidate may be required to perform other duties toward HEDIS collection as assigned including HEDIS medical record review and outreach for collection of medical records. This is a fast-paced environment and candidates must adhere to measured productivity and accuracy requirements. The candidate is required to attain a score of 100% on specific measure testing prior to conducting live medical record reviews and overreads. Candidate must also be able to achieve and maintain a quality reliability score of 95% or higher to remain eligible for employment for the duration of the project.
- Follow established procedures for conducting Quality Assurance Overread reviews of abstracted medical records
- Extract electronic medical record data using multiple systems
- Enter pertinent data from paper and electronic medical records into database as required by established quality assurance abstraction procedures
- Communicates effectively and professionally
- Meet or exceed productivity and accuracy requirements
- Ability to work independently and in team environment
- Excellent time management and prioritization skills
- Excellent communication skills (written and verbal)
- Strong attention to detail
- Ability to multi-task
- Flexibility with assignment change
- Highly organized
- Evidence of strong computer skills including the Microsoft office suite (e.g., Microsoft Outlook, Excel, and Word)
- Maintain patient confidentiality by protecting patient information from unauthorized disclosure
- Other duties as assigned
- Must have reliable internet connection and experience working in a remote setting
3-5 Years Recent HEDIS Medical Record Review Experience Preferred
Quality improvement or medical record review experience preferred
