RN Trainer Auditor PRN

Job Description:

To review medical records retrieved from provider offices and abstract medical information for HEDIS (Health Effectiveness Data Information Set) annual audits. Interprets relevant clinical criteria through review of medical records annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS, CMS, and STARS performance measures.

Job Essentials

• Work collaboratively with SelectHealth’s HEDIS Manager, Quality Consultants, and Data Analyst
• Responsible for performing accurate and comprehensive medical record reviews using a proprietary abstraction tool and software on an assigned laptop
• Reviewer will perform remote or offsite medical record reviews with charts collected from provider offices, clinics and hospitals for the purpose of obtaining documentation to support the HEDIS project. Records will be retrieved by third party vendor, fax, remote EMR access and/or mail processes
• Locate and review all assigned medical charts, perform abstraction, mark-up supporting documentation per audit specifications
• Proven organizational and time management skills including the ability to meet required deadlines. Work with provider offices as needed to schedule/confirm appointments, and follow up on medical record requests
• Calls members to gather procedural information on when and where the member received are and verify care was received.
• Reviewer must pass a medical record abstraction test prior to beginning the project and will need to maintain minimum competency throughout the project
• Frequent interactions with providers, members that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues accurately

Minimum Qualifications

-Current RN license in state of practice.
-Current driver's license and access to personal vehicle to be able to travel to multiple local offices.
-Three years of clinical experience in hospital, and/or physician office.
-Computer skill in word processing and spreadsheets.
-RNs with less than 12 months of working experience as an RN prior to joining Intermountain must obtain their BSN within five years of their start date.

Preferred Qualifications

-Bachelor's Degree in Nursing (BSN) from an accredited institution.
-Effective organizational skills and written and verbal communication skills.

Ongoing need for employee to see and read information, assess member needs, and view computer monitors.
– and –
Frequent interactions with providers, members that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues accurately
– and –
Manual dexterity of hands and fingers, this includes frequent computer use and typing for documenting member care, accessing needed information, etc.

Location:

SelectHealth – Murray

Work City:

Murray

Work State:

Utah

Scheduled Weekly Hours:

0

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$35.22 – $53.29

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

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