Clinical Medical Review Nurse HEDIS Retrospective Project

The Clinical Medical Review Specialist (a professional with clinical experience) will report to the Clinical Support Supervisor HEDIS and be part of the Quality Team. The main duties include chart retrieval, using proprietary tools and software to conduct thorough medical record reviews in line with NCQA specifications, retrieval follow-up, and escalating issues as needed. Main duties will be assigned according to experience, knowledge, skills, and abilities. This role requires extensive knowled

Terms of Employment Contract, 6 Months (Possible Extension / Permanent Conversion) This position requires residence in Maryland and the ability to work on-site at our client's Baltimore, MD (Canton neighborhood) office 2-3 days per week. Occasional travel to local healthcare provider offices will also be required. Overview & Responsibilities Join a dedicated Government Programs quality team at a leading healthcare organization. We are seeking five skilled and detail-oriented Clinical Review Nurs

Please, no agencies or recruiters, only W2 applicants. Vega Consulting is staffing a Utilization Review Specialist for our direct Healthcare client. Primarily remote, with the exception of candidates will be required to attend Training the week of December 14th and occasionally travel to provider sites. This is a 6-month+ contract, hybrid role. Candidates license for Maryland, VA or Wash DC. (RN or LPN). Duties include chart retrieval, using proprietary tools and software to conduct thorough med

Clinical Medical ReviewNurse (HEDIS Medical RecordsRetrieving) Columbia, MD (Primarily remote, but hybrid) 6 Months+ PURPOSE: Seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a payer, health insurance, or HEDIS vendor environment. The ideal candidate will understand NCQA healthcare quality metrics and have a proven ability to accurately abstract, interpret, and document medical record data for HEDIS gap closure. This role will support me