HEDIS Abstractor - RN

Overview

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA

Under the direction of the HEDIS team lead, Quality Management, the HEDIS Medical Records Specialist is responsible for conducting the Chart Collection and Chart Abstraction portion of the HEDIS (Healthcare Effectiveness Data and Information Set) Audit. The Specialist is responsible for providing basic administrative and telephonic support for the Quality Improvement department in order to meet deadlines associated within the project. They will coordinate with provider offices to verify information, transfer documents, schedule onsite visits if needed.

Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

Responsibilities

Essential Functions

• Ensures timely and accurate collection of medical records from provider offices
• Uses clinical knowledge to efficiently and accurately abstract HEDIS data from medical record into HEDIS software
• Call providers and request medical records
• Book appointments for HEDIS onsite chart review
• Communicate effectively and professionally with providers
• Research within the company's claim systems to identify provider location
• Retrieve previously scanned or filed information
• Oversee incoming and outgoing fax documents
• Assemble and scan and/or upload documents
• Maintain tracking log and calendar
• At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role.

Knowledge / Skills / Abilities

• Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment.

• Ability to perform the essential functions of the job as outlined above

• Strong attention to detail

• Ability to manage multiple priorities and meet deadlines

• Knowledge of Microsoft Office applications

• Knowledge of electronic medical record systems

Qualifications

Required

• Three years of clinical and critical nursing experience

Licenses Required

• Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah.

* Additional license requirements as determined by the hiring department.

Qualifications (Preferred)

Preferred

• HEDIS experience
• Experience with HEDIS vendor software
• Knowledge of health insurance and managed care operations

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

• This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements