What are the responsibilities and job description for the HEDIS LVN - REMOTE position at Actalent Services?
One of California's biggest health plans is looking for 8, FULLY REMOTE LVNs to join their HEDIS team!
Job Description:
This position will be in support of the HEDIS Medical Record Review (MRR) cycle. The individuals will work directly with HEDIS MRR Program Manager and other medical record reviewers to review medical record. Primary responsibility will be to perform medical record review, & enter findings into abstraction tool (Inovalon QSHR) and to over read. Identify chase opportunities from the medical record. Coordinate with Program Manager, and administrative staff to manage caseload for teams. Communicate with team members to effectively manage project assignment .Researches and designs treatment /care plans to promote quality of care, cost effective health care services based on medical necessity complying with contract for each appropriate plan type. Implements discharge (DC) planning activities for medically complex cases. Ensures DC planning at levels of care appropriate for the members needs and acuity. Determines appropriateness of referral for CM services. Coordinates care for Lower Level of Care such as Residential Treatment,
Requirements:
- CA LVN License
- Previous HEDIS experience A MUST
- Ability to maintain a high volume of abstractions
Schedule: 8 hour shifts, 40 hours a week, start time between 6am-8am, possible OT
Job Types: Full-time, Contract
Pay: $30.00 - $38.00 per hour
Expected hours: 40 per week
Schedule:
- 8 hour shift
- Day shift
Application Question(s):
- How many seasons of HEDIS have you done?
License/Certification:
- LVN (Required)
Work Location: Remote
Salary : $30 - $38