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For 20 years, we have been privileged to partner with the Centers for Medicare and Medicaid Services (CMS), supporting their vital mission to improve healthcare across the U.S. healthcare system.
Since 2014, we have collaborated with more than half of the U.S. states through direct contracts with state health agencies, advancing healthcare quality and safety initiatives. We are also proud to have supported a leading non-profit cardiothoracic surgery organization.
Our success is strengthened by our valued collaborations with exceptional prime and subcontractors, whose expertise enhances and complements our own.
Position Summary
Healthcare Management Solutions (HMS) is seeking experienced clinical reviewers to support the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database (CHSD) Audit Program. The CHSD Reviewer is responsible for conducting independent reviews of medical records and comparing source documentation against data submitted to the STS registry. The reviewer evaluates the accuracy, completeness, and consistency of registry data; identifies discrepancies; and documents findings in accordance with STS audit methodologies and HMS quality standards.
This is a remote, part-time position requiring strong clinical knowledge of congenital cardiac procedures, excellent attention to detail, and the ability to work independently while meeting established quality and productivity expectations.
Essential Duties and Responsibilities
- Review and audit clinical data submitted to the STS Congenital Heart Surgery Database against source medical record documentation.
- Validate case selection, procedure coding, outcomes, and registry variables for completeness and accuracy.
- Identify and document matches, mismatches, and potential data quality concerns using HMS audit tools.
- Review operative reports, progress notes, diagnostic studies, discharge summaries, and other medical record documentation relevant to congenital cardiac procedures.
- Participate in initial and ongoing reviewer training activities.
- Meet established productivity, quality, and inter-rater reliability standards.
- Escalate questions regarding data definitions, documentation interpretation, or audit findings through established channels.
- Participate in adjudication activities and documentation review when sites respond to preliminary audit findings.
- Provide clear, professional documentation regarding audit determinations and supporting rationale.
- Maintain confidentiality and comply with all HMS security, privacy, and data protection requirements.
- Participate in team meetings and project calls as needed.
- Perform other duties as assigned.
Required Qualifications
- Registered Nurse (RN), physician, physician assistant, nurse practitioner, perfusionist, or other clinically licensed healthcare professional.
- Minimum two years of recent clinical, registry abstraction, quality improvement, or audit experience.
- Experience reviewing complex medical records.
- Strong understanding of clinical documentation requirements and medical terminology.
- Proficiency with Microsoft Office applications and electronic medical records.
- Ability to work independently in a remote environment.
- Strong analytical, organizational, and communication skills.
- Ability to meet established deadlines and quality standards.
Preferred Qualifications
- Direct experience with the STS Congenital Heart Surgery Database (CHSD).
- Previous experience performing registry audits or data validation activities.
- Clinical experience in pediatric cardiology, congenital heart surgery, pediatric intensive care, cardiovascular surgery, or related specialties.
- Familiarity with STS data definitions, abstraction guidelines, and performance measures.
- Experience with Epic, Cerner, Meditech, or other major EMR platforms.
- Experience interpreting operative reports and congenital cardiac procedure documentation.
Knowledge, Skills, and Abilities
- Knowledge of congenital cardiac anatomy, procedures, and terminology.
- Ability to accurately interpret clinical documentation and apply registry definitions.
- Strong attention to detail and commitment to data quality.
- Ability to manage multiple assignments simultaneously.
- Ability to communicate professionally with project leadership and team members.
- Ability to learn and apply new audit tools, processes, and guidelines quickly.
EOE STATEMENT
Healthcare Management Solutions, LLC has established an Affirmative Action Plan. HMS is deeply committed to the concept and practices associated with equal opportunity and affirmative action in all aspects of employment. HMS makes clear that all applicants will be treated without regard to race, color, sex, religion, national origin, age, disability, genetic information, sexual orientation, ancestry, marital status, changes in marital status, pregnancy or parenthood, gender, or gender identity or expression, military or veteran status, political affiliation, or any other protected characteristics under applicable law when the reasonable demands of the position(s) do not require distinction on the basis of age, disability, sex, marital status, changes in marital status, pregnancy, or parenthood.
This company does not tolerate unlawful discrimination in its employment practices. We recognize the value of diversity in our workforce and encourage all qualified candidates to apply. We thank all candidates who choose to apply, however, only those selected for a further interview will be contacted.
Equal Opportunity Employer/M/F/Vet/Disabled
HMS is an EEO/AA/E-Verify compliant and drug free workplace employer.
