North Highlands CA 95660
Inspiring Hedis Nurse wishes to obtain a career with an established hospital looking for loyal employees who are dedicated to their hospital.
Summary of Qualifications:
- Ability to collected from medical records, immunization registries, member documents and provider office
- Excellent interpersonal and organizational skills
- Effective problem solving, analytic and communication skills
- Professional phone etiquette
- Amazing ability to demonstrate appreciation of cultural diversity and sensitivity towards target population
- Remarkable ability to work calmly and effectively under adverse conditions
Hedis Nurse, August 2005 – Present
Amerigroup, Aurora, CO
- Educated provider and office staff about medical records and clinical standard guidelines.
- Assisted in defining opportunities for improvement through analysis of patterns and trends.
- Communicated significant findings, including potential risk management issues to the Quality Management.
- Performed on-site medical record reviews.
- Adhered to established procedures for scheduling, requesting, and reviewing records while on-site at provider offices and hospitals.
Hedis Nurse, May 2000 – July 2005
CareSource, Aurora, CO
- Collected, researched and organized information to use in reviews.
- Reported reviews not meeting criteria to peer consultants, including medical directors.
- Maintained complete confidentiality of protected health information.
- Communicated with management regarding development within areas of assigned responsibilities.
- Gathered, entered, and analyzed data.
- Performed Medical Reviews in Physicians offices throughout the state.
Bachelor of Science in Nursing Practitioner, Central Pennsylvania College, Summerdale, PA
5931 S Olive St
Hesperia, CA 92344
Seeking a responsible position as a Hedis Nurse in a well reputed hospital or clinic where my experience and knowledge are fully employed.
- Strong interpersonal, organizational, problem solving, analytic and communication skills.
- Excellent ability to perform on-site medical record reviews.
- Profound ability to communicate significant findings, including potential risk management issues to the quality management lead in a timely manner.
- Extended ability to analyze, interpret and relate the medical data.
- In-depth knowledge of the medical terminology.
Hedis Nurse, 2004 to till date
Roswell Park Cancer Institute, Buffalo, NY
- Collected and analyzed health care data.
- Educated providers and office staff about medical records and clinical standard guidelines.
- Collected, analyzed, and reported initiatives and facility compliance with HEDIS population health measures.
- Requested and reviewed appropriate medical records.
Certified Registered Nurse Practitioner (CRNP), 2004
University of Illinois, Chicago, IL
B.S in Nursing, 2003
Yale University, New Haven, CT