Position Overview:
The primary function of the Clinical Quality Reviewer - Seasonal is to conduct audit of medical charts for compliance with HEDIS, QARR, Medicare Advantage Star measure specifications. This position will be an integral part of the annual Medical Record Review project required to report HEDIS/QARR measures to the NYS Department of Health and Centers for Medicare & Medicaid Services (CMS). The role is seasonal and will be needed from November of the measurement year through May of the reporting year, approximately seven months.
The position may require travel within the five boroughs.
Scope of Role & Responsibilities:
Licensure and/or Certification Required:
Clinical background: Health Educator, LPN, RN, LMSW or LCSW with a minimum of two years HEDIS review experience
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