*Healthcare Consultant II
: Job Details :

Participates in the audit/overread of the medical record collection and review process for HEDIS quality reporting. Audits and interprets relevant clinical criteria through review of medical records. Annotates via Adobe PDF and audits data populated within a data collection tool to support compliance with HEDIS and CMS performance measures. Ensures accurate and complete documentation of required information to meet risk management regulatory and accreditation requirements. Maintains project productivity levels while ensuring accuracy in abstraction and data entry activities. Critical Information Candidate must be proficient with databases and conduct 100% of work activities on the computer. Medical knowledge and terminology is required. Must maintain confidentiality of PHI, HIPAA Privacy and Security Rules. Education/ Licenses Needed RN/ LVN with an associate or bachelor degree is preferred but not required. Successful HEDIS review experience may be substituted for licensure....Healthcare, Consultant, Health, Staffing