$26/hr – $29/hr Healthcare Consultant (Hedis) (Nursing license preferred)

Nov 8, 2024

LanceSoft

Data Abstraction, Entry Level, HEDIS, Licensed Practical Nurse | LPN | LVN, Quality, Registered Nurse | RN
May require travel to physician offices; Nursing license preferred but not required.

Employment Type:

Contract Employee

Schedule:

Full-time, Temporary | Seasonal

Remote Status:

Hybrid, Local or Regional Travel

License:

IL

LanceSoft

Data Abstraction, Entry Level, HEDIS, Licensed Practical Nurse | LPN | LVN, Quality, Registered Nurse | RN
May require travel to physician offices; Nursing license preferred but not required.

Employment Type:

Contract Employee

Schedule:

Full-time, Temporary | Seasonal

Remote Status:

Hybrid, Local or Regional Travel

License:

IL

      

       About the job
      

      

        

         

Job Description:

Job Title: ‘HEDIS Reviewer II’

Estimated Length of Assignment: 06+ Months With Possible Extension (01/02/2025 to 06/27/2025)

(The dates provided are only an estimate and not a guarantee)

Est. Pay Range: $26.00/Hour – $29.00/Hour on W2 (USD)

Work Type: Remote Role (Work from Home, IL)

Schedule – 8am -5pm CST

   

  • Participates in the review of medical records to abstract clinical information for HEDIS reporting.
  • May require travel to physician offices; Nursing license preferred but not required.
  • Successful HEDIS review experience may be substituted for licensure.

Duties

   

  • Interprets relevant clinical criteria and/or medical policy/benefits for an identified case. Determines when to consult appropriate provider or practitioner and to review case with medical Director for additional action.
  • Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements.
  • Prepares and reports business information to internal and external constituents. Consults with the constituents on solutions to business issues.
  • Identifies trends involving clinical issues and reports/recommends solutions to senior management and others.
  • Conducts audits and/or assessments to determine compliance with guidelines. Identifies gaps and May assist in the development/re-evaluation of corrective action plans.

Experience

   

  • 2-4 years audit or related business experience required.
  • 2 years Clinical Experience Required Preferred
  • Managed Care experience preferred

Position Summary

   

  • Participates in the review of medical records to abstract clinical information for HEDIS reporting.
  • May require travel to physician offices; Nursing license preferred but not required.
  • Successful HEDIS review experience may be substituted for licensure

Education

   

  • High School Diploma/GED