Hedis Nurse Resume

Samantha Gray

North Highlands CA 95660

(916) 987-6543

[email protected]

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Job Objective

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

Work Experience:

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.

Education

Bachelor of Science in Nursing Practitioner, Central Pennsylvania College, Summerdale, PA

Example #2

Melanie Gonzalez

5931 S Olive St

Hesperia, CA 92344

(777)-777-7777

[email protected]

Objective

Seeking a responsible position as a Hedis Nurse in a well reputed hospital or clinic where my experience and knowledge are fully employed.

Career Profile:

  • 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.

Nursing Experience:

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.

Academic Background

Certified Registered Nurse Practitioner (CRNP), 2004

University of Illinois, Chicago, IL

B.S in Nursing, 2003

Yale University, New Haven, CT