Medix is currently hiring for a temporary part time Utilization Review RN position. This role does require traveling to different locations. This is a part time contract role running from Januray-March.
Responsibilities:
- Review and abstract medical data from diverse sources including paper and electronic medical records
- Review assigned medical records in order to abstract specified and required clinical data elements for GPRO reporting
- Comply with appropriate procedures for scheduling, requesting, and reviewing records on-site
- Performing complete and accurate data entry of qualifying services and results into proprietary software
- Identifying and communicating patterns of missing documentation for the assessment of additional records
- Routing all exclusions and complex issues to the Quality Manager or Project Manager
- Communicate all project issues including scheduling, assignment, fax/mail correspondence, and supervisor alerts in a timely manner
- Successfully completing GPRO Reviewer training
- Successfully completing GPRO software training and using software correctly to facilitate accurate reporting and ongoing progress of the annual GPRO project
3-5 Must Have Skills/Qualifications - RN or LPN NJ license
- Previous experience in medical record review, data abstraction, quality management, GPRO or HEDIS measures within the past 4 years
- Strong clinical background with comprehensive experience
- Understanding of codes for services based on diagnosis and procedure
- Well versed w/ EMR
- Graduate of an accredited School of Nursing
Schedule: Monday-Friday 8am-5pm (can work 1-3 days per week schedule is flexible)
Medix is acting as an Employment Business in relation to this vacancy.