Auto req ID 1981BR Company BlueCross BlueShield of WNY About Us BlueCross BlueShield of Western New York is a division of HealthNow New York Inc., one of New York’s leading health care companies that provides access to quality health care and solutions for members throughout Upstate New York. Since 1936, BlueCross BlueShield has helped millions of people gain access to health care. Headquartered in Buffalo, NY, the company is an independent Licensee of the BlueCross BlueShield Association. As the region’s leading health plan, serving over 800,000 members, BlueCross BlueShield believes in taking small steps towards healthier living. You can visit our website at www.bcbswny.com. Title Temporary - HEDIS Review Position Posting Location Buffalo Status Full Time Temporary Hours 8am-5pm Job Description Under the supervision of the HCQI HEDIS Coordinator performs medical record collection and abstraction in support of the annual HealthCare Effectiveness Data and Information Set (HEDIS) Project Primary Responsibility Medical record collection and abstraction in support of the annual Healthcare Effectiveness Data and Information Set (HEDIS) with duties including but not limited to:
On an annual basis develops expertise in the requirements and parameters of HEDIS performance measures.
Applies HEDIS criteria to medical records to determine compliance with current year HEDIS specifications.
As required, visits to provider sites to identify copy and collect selected medical records.
Accurately enters the results of all chart reviews into a HEDIS database (McKesson Compliance Reporter).
Utilizes various software applications to support HEDIS abstraction (Facets, Streamline-claims research, Content Manager-record review, etc.).
Communication with offices as necessary to insure accuracy of data collection.
Maintains a less than 5% error rate in record abstraction and data entry.
Maintains productivity level as determined by the HCQI HEDIS Coordinator.
Performs other duties as directed Knowledge and Skills Excellent time management skills and attention to detail. Excellent communication and documentation skills. Ability to work effectively with minimal supervision. Ability to complete tasks accurately within established timelines. Able to work in a team setting. Ability to establish and maintain effective and cooperative working relationships with HNNY HEDIS project staff and provider offices contacted in the course of job responsibilities. Ability to maintain confidentiality. Demonstrated personal accountability. Basic computer knowledge. Experience with various EMR (electronic medical record) systems and HEDIS and/or medical record abstraction of clinical information. Successful completion of HEDIS Medical Record Review Training Course with a minimum score of 95%. Ability to consistently apply HEDIS standards with at least an accuracy of 95% inter-reliability rating throughout project. Valid drivers license and reliable transportation. Qualifications Nursing professional (RN or LPN), certified coder or other NYS recognized Qualified Healthcare Professional. EEO Statement All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status. Removal Date 17-Sep-2019