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VIVA USA Inc Healthcare Consultant in Remote, Rhode Island

Description: Participates in the audit/over-read of the medical record collection and review process for HEDIS quality reporting. Training will be provided prior to the start of the assignment. This position 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. The candidate must be proficient with databases and with conducting 100% of work activities on the computer. • 5 or more years of HEDIS experience in reviewing medical records is required • Prior experience in performing chart audits is preferred. • Candidate must commit to attend all required training and conference calls assigned for the project. • Candidate must return all equipment that is supplied to them in good working condition and in a timely manner at the end of the project • 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 • Workspace able to accommodate laptop and up to 2 monitors • Reliable internet connection • Private uninterrupted workspace to maintain HIPAA Privacy and Security Rules N/A • Auditing of information entered into the software system for abstraction and data entry based on HEDIS MY 2021 Technical Specifications. • Prioritize and accurately complete tasks within established times • Identifying trends and documentation of areas for improvement • Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities RN/LVN with an associate or bachelor degree is preferred but not required. Successful HEDIS review experience may be substituted for licensure. M-F 8-5 Fully Remote Work from Home VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.