HEDIS Medical Review Nurse

Terms of Employment

  • Contract, 6 Month
  • This is primarily remote. However, the resources may occasionally be required to visit provider offices for record retrieval and come onsite to Baltimore, MD, and/or Owings Mills, MD for (infrequent) meetings. There is one week of onsite training.

Overview

Our client is seeking a HEDIS Quality Specialist to join their Quality Team and support their annual HEDIS project. This role involves assisting with medical record retrieval and abstraction and working closely with providers to ensure complete and accurate documentation. Ideal candidates will have a strong clinical background, critical thinking skills, and be comfortable analyzing medical records. Compliance with HIPAA and confidentiality standards is required, along with other duties as assigned. Applicants must be detail-oriented and able to work independently while maintaining a high level of accuracy.

Onsite Training

  • Onsite training from January 27th – January 31st
  • Location in Canton or Owings Mills.
  • Attendance is mandatory during the training period, as it follows a structured schedule. Missing even one day can result in significant gaps in essential knowledge.

Responsibilities

  • Assist with the retrieval of medical records and abstraction of key information for HEDIS reporting.
  • Analyze clinical records, identify missing information, and work with providers to gather required data.
  • Shift from record retrieval to abstraction based on project needs.
  • Request additional information from providers when necessary.
  • Maintain accurate records and ensure compliance with HEDIS guidelines.

Required Skills & Experience

  • Experience with at least two HEDIS seasons as a Certified Medical Assistant or LPN
    • Note: Recent graduates from nursing school are encouraged to apply; the HEDIS experience requirement may be waived.
  • Experience with medical record retrieval, HEDIS abstraction, and working within Electronic Medical Records (EMR) systems.
  • Clinical background with strong critical thinking skills.
  • Medical record analysis experience or clerical experience in a clinical setting.
  • Open-minded, detail-oriented, and capable of working in a fast-paced environment.
  • Strong communication skills, particularly with healthcare providers.

Preferred Skills & Experience

  • Nursing Degree

nTech is an equal opportunity employer. All offers of employment are contingent upon pre-employment drug and background screenings. Only candidates who meet all of the above client requirements will be contacted by a recruiter.

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