Experienced Healthcare Consultant - Hedis II: Remote Opportunity for Medical Records Review and Quality Reporting

About Our Company

We are a leading healthcare consulting firm dedicated to delivering high-quality services that drive excellence in patient care and outcomes. Our team of experts is passionate about making a positive impact in the healthcare industry, and we're excited to welcome a talented Healthcare Consultant - Hedis II to our remote team. Job Summary We're seeking an experienced Healthcare Consultant - Hedis II to join our remote team and contribute to our mission of improving healthcare quality and outcomes. As a key member of our team, you will be responsible for reviewing medical records, abstracting clinical information, and ensuring accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements.

Key Responsibilities

• Participate in the collection and review of medical records to abstract clinical information for HEDIS quality reporting.
• Interpret relevant clinical criteria through review of medical records, annotate via Adobe PDF, and populate a data collection tool to support compliance with HEDIS and CMS performance measures.
• Ensure accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements.
• Work with provider offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters.
• Locate and review ALL assigned medical charts, perform abstraction, copy all supporting documentation per specifications, and data enter into the applicable software system ALL assigned abstracts.
• Prioritize and accurately complete tasks within established times.
• Identify trends and documentation of areas for improvement.
• Maintain project productivity levels while maintaining accuracy requirements for abstraction and data entry activities.

Essential Qualifications

• 0-3 seasons of experience auditing and abstracting medical records required.
• Medical knowledge/terminology is required.
• Ability to read and interpret medical records.
• Professional demeanor and good work ethic.
• Computer savvy: Microsoft Word, Excel, email, and Adobe reader required. Know how to save a file to a folder.
• Excellent verbal and written communication skills – clear, concise, and appropriate.
• Conscientious problem solver, willing to learn, and take personal pride in their work performance/accuracy.
• Exceptional attention to detail and excellent analytical, investigation, and problem-solving skills.
• Proven organizational and time management skills including the ability to meet required deadlines.
• Must keep all information collected in a safe, organized, and confidential manner while maintaining confidentiality of PHI, HIPAA Privacy and Security Rules Apply.

Preferred Qualifications

• Experience working with HEDIS and CMS performance measures.
• Knowledge of medical terminology and coding systems (e.g., ICD-10, CPT).
• Experience working with electronic health records (EHRs) and data collection tools.
• Strong analytical and problem-solving skills, with the ability to identify trends and areas for improvement.
• Excellent communication and interpersonal skills, with the ability to work effectively with healthcare providers and other stakeholders.

Skills and Competencies

To succeed in this role, you will need to possess a unique combination of skills and competencies, including:

• Strong analytical and problem-solving skills, with the ability to identify trends and areas for improvement.
• Excellent communication and interpersonal skills, with the ability to work effectively with healthcare providers and other stakeholders.
• Ability to work independently and as part of a remote team.
• Strong organizational and time management skills, with the ability to meet required deadlines.
• Proficiency in Microsoft Office, including Word, Excel, and email.
• Knowledge of Adobe PDF and data collection tools.
• Ability to maintain confidentiality of PHI and adhere to HIPAA Privacy and Security Rules.

Career Growth

Opportunities and Learning Benefits We offer a range of career growth opportunities and learning benefits to support your professional development and success, including:

• Opportunities for advancement and professional growth within the company.
• Access to ongoing training and development programs, including webinars, workshops, and conferences.
• Collaboration with experienced professionals and thought leaders in the healthcare industry.
• Opportunities to contribute to and participate in company-wid