HEDIS Nurses assess whether healthcare services comply with prescribed Healthcare Effectiveness Data Information Set (HEDIS) measurements. They abstract clinical data from medical records and documents, prepare integrated reports from collected data, and document their findings for physicians and healthcare facility managers to act upon.
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HEDIS Nurse Job Description Template
We are looking for a highly capable HEDIS Nurse to gather and analyze HEDIS performance data. In this role, you will be reviewing assigned medical records, abstracting relevant clinical data, and reporting to the health facility's managers on whether healthcare provision standards are being met.
To ensure success, HEDIS Nurses should exhibit extensive experience in analyzing medical records and sound knowledge of HEDIS measures. An accomplished HEDIS Nurse will be someone whose expertise will translate into HEDIS compliance and the highest of standards in providing healthcare services.
HEDIS Nurse Responsibilities:
- Reviewing medical records and documents to abstract clinical data for HEDIS reporting.
- Integrating collected electronic and hardcopy data into reports.
- Documenting findings in applicable HEDIS databases and on prescribed cloud-based platforms.
- Meeting daily abstraction goals and maintaining a high abstraction accuracy percentage.
- Performing on-site facility audits for compliance with HEDIS measures.
- Preparing and presenting HEDIS compliance reports to health facility managers.
- Training and advising healthcare professionals and administrative staff on HEDIS compliance.
- Maintaining HIPAA standards and immediately reporting any critical findings to designated authorities.
- Keeping abreast of HEDIS measures.
HEDIS Nurse Requirements:
- Bachelor's Degree in Nursing.
- State-approved licensing and registration as a nurse (RN, LPN, or LVN).
- Extensive experience with HEDIS database entries and reporting.
- Proficiency in Electronic Medical Record (EMR) software and cloud platforms, such as Cliniko and Inovalon.
- A minimum of two years' experience in a similar role.
- In-depth knowledge of abstracting clinical data and evaluating HEDIS compliance.
- Advanced knowledge of medical terminology, coding, and procedures.
- Extensive experience in interpreting and reporting HEDIS information, as well as training staff.
- Ability to keep informed of HEDIS measures and healthcare standards.
- Excellent organizational and communication skills.
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