Description:
We are seeking a dedicated and meticulous HEDIS Nurse to assist with the collection, analysis, and presentation of healthcare data. The HEDIS Nurse will be responsible for managing all aspects of the HEDIS (Healthcare Effectiveness Data and Information Set) process, including data collection, verification, and report generation. Our ideal candidate will have experience with HEDIS measures, strong analytical skills, and a deep understanding of healthcare systems and regulations. Ultimately, the HEDIS Nurse ensures that our healthcare services maintain a high level of quality, effectiveness, and compliance with regulatory standards.
Responsibilities:
• Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards
• Review medical records and abstract data for HEDIS and other measure sets in compliance with standards
• Track and report on issues and outcomes related to abstractions and over-reads
• Communicate outcomes of abstraction and over-sight activities with health plans and vendors when required
• Perform other quality initiatives as necessary
Qualifications:
• Registered Nurse (RN) license.
• Experience with HEDIS measures and data abstraction.
• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Proficiency in healthcare data systems and software.
• Ability to work independently and as part of a team.
• Attention to detail and strong organizational skills.
Preferred Qualifications:
• Bachelor's degree in Nursing or related field.
• Certification in HEDIS or healthcare quality improvement.
• Experience in healthcare quality improvement or clinical auditing.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U. S. , Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
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