Adecco Medical & Science is hiring a Call Center Nurse with HEDIS Experience! This role is remote. Please read below and apply with an updated resume for consideration.
Type: 12-month contract
Schedule: 8 am to 5 pm, Monday – Friday
Pay: $40 to $42 per hour
Location: Telecommute, prefer EST or CST
Responsibilities of the Call Center Nurse:
• Oversight and direction of nurse clinical quality contractor work.
- Performs provider/practitioner medical record reviews for HEDIS® and HEDIS®-like measures
• Conduct outreach to member’s to inquire about preventive care and communicate available plan services and benefits
• Reviews assigned medical records in order to verify clinical data elements for HEDIS® reporting, e.g., results of laboratory tests, verification of hypertension and the most recent blood pressure reading, transitional care services)
• Integrates data collected from a variety of electronic and paper sources
• Demonstrates intermediate proficiency in Microsoft Office: Access, Outlook, Excel, and Word and similar applications
o Manages various data organized within Excel spreadsheets
• Identifies findings supported by documentation guidelines with high level of accuracy
• Maintains HIPAA standards and confidentiality of protected health information; reports critical incidents immediately
• Communicates identification of pursuit leads for additional medical records, if needed, to other members of the team
• Attends conference calls as necessary to provide information relating to clinical reviews and compliance
• Successfully completes HEDIS® technical specification training and testing
• Successfully completes HEDIS® software training and uses software correctly
• Responsible for meeting daily production goal
Qualifications for the Call Center Nurse:
• Minimum of 3 + years of supervisory experience.
- BSN from accredited program with unrestricted licensure in any state
- Minimum 3 year healthcare/health plan experience
• Minimum 3 year HEDIS® experience and/or knowledge
• Solid knowledge of managed care requirements related to clinical quality
• Research and detail oriented, excellent proof-reading skills
• Excellent time management and prioritization skills
• Designated workplace inside home (virtual)
• Reliable internet connection (virtual)
• Strong communication skills
• Strong proficiency with Microsoft Office applications, including: Word, Excel, Adobe, and PowerPoint
• Critical thinking skills
• Results-driven independent worker and self-starter
Why work for Adecco?
· Weekly Pay
· 401(k) Plan
· Skills Training
· Excellent medical, dental, and vision benefits
Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.
Pay Details: $40.00 to $42.00 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.