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HEDIS Abstractor - (9311)

Universal Health Services


Date:
11/16/2017
2017-11-162017-12-15
Job Code:
9311
Universal Health Services
Apply on the Company Site
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Job Details

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Job Details


HEDIS Abstractor - (9311)

Facility Name
Prominence Health Plan
Location
RENO, NV 89502 US (Primary)
Career Area
Allied Health
Category
Registered Nurse (RN)
Job Description

Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected health care management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide. Founded in 1978, UHS subsidiaries now have more than 65,000 employees. The UHS business strategy is to build or purchase health care properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control. Our success comes from a responsive management style and a service philosophy based on integrity, competence and compassion.

Prominence Health Plan, established in Reno in 1993 as St. Mary’s Health Plan, was acquired in 2014 by Universal Health Services (UHS), one of Fortune Most Admired Companies. 

In addition to the HMO, Prominence Health Plan also offers Point of Service health plans, a preferred health insurance company that offers Preferred Provider Organization (PPO) health plans, and CDS Group Health, a third-party administrator.

Job Summary:  A Registered Nurse position performs medical record abstraction in support of the Healthcare Effectiveness Data and Information Set (HEDIS) data collection.  Responsible for interacting with provider offices, either onsite or telephonically to access medical records.  The HEDIS Chart Abstractor will possess advanced clinical and healthcare knowledge as well as advanced knowledge of NCQA HEDIS abstracting guidelines, with the ability to access medical records (electronic and paper).  The Abstractor will be able to accurately identify required data and information, extract and organize this data and enter into a HEDIS software database.

 We are a fast-growing, rapidly-changing healthcare organization offering the excitement of a start-up with the support of a Fortune 500 company. We are looking for talented, enthusiastic people to help shape the future of our organization.

Job Requirements

Regulatory Requirements:

  • Registered Nurse License required.
  • 2+ years of experience performing HEDIS medical record abstraction in commercial, Medicare or Medicaid programs.
  • Thorough understand of Medicare HEDIS measurements
  • Experienced in  training/educating provider community on proper documentation strategies
  • Experience working with multiple Electronic Medical Records (EMR's) and consulting medical groups on best practices for HEDIS performance

Language Skills:

  • Ability to effectively communicate in English, both verbally and in writing.

Skills:

  • Advanced knowledge of NCQA and HEDIS data collection
  • Ability to work independently and accurately
  • Ability to follow instructions precisely
  • Familiarity with electronic and paper medical record systems
  • Ability to identify specific data within the medical record
  • Familiarity and capacity to learn various data entry systems
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