You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a HEDIS Reviewer to perform Healthcare Effectiveness Data and Information Set (HEDIS) medical record review, supplemental data validation, data abstraction, and clinical data quality activities. This role utilizes internal and external clinical data sources to support accurate, timely, and compliant collection of clinical data for HEDIS reporting, regulatory submissions, and quality improvement initiatives.
Key Responsibilities
- Perform HEDIS medical record review.
- Conduct supplemental data validation.
- Execute data abstraction activities.
- Perform clinical data quality activities using internal and external clinical data sources.
- Support the accurate, timely, and compliant collection of clinical data for HEDIS reporting.
- Contribute to regulatory submissions and quality improvement initiatives.
Qualifications
- Registered Nurse (ASN or BSN).
- At least 1 year of HEDIS review experience.
- Ability to work independently and manage high-volume workloads.
- Tech-savvy with experience navigating multiple EMR systems, including E Clinical Works (ECW).
- Comfortable working in fast-paced environments while maintaining composure.
- Skilled at exercising discretion when handling confidential information.
- Experience with HEDIS Measures such as BCS-E (Breast Cancer Screening), COL-E (Colorectal Cancer Screening), and EED (Eye Exam for Patients with Diabetes).
Experience
- Minimum of 1 year of HEDIS review experience.
Skills
- Proficiency with various EMR systems, specifically E Clinical Works (ECW).
- Demonstrated ability to work in fast-paced, high-volume environments.
- Strong independent work ethic.
- Excellent discretion and handling of confidential information.
- Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) measures.
Education
- Registered Nurse (ASN or BSN).
Additional Requirements
- Schedule: Monday – Friday, 8:30 AM to 5:00 PM.
- Required in-office presence Tuesday – Thursday.
Benefits
- Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
- Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
- 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
- Short Term Disability Insurance.
- Term Life Insurance Plan.
*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
Any required state or Joint Commission training is compensated at the state or local minimum wage rate.
*As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient’s residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
