Licensed Vocational Nurse /LVN – Utilization Review (HEDIS Abstractor)

• This person will be abstracting data from medical records and entering into the database. They will occasionally be traveling to provider offices and work with their staff to review charts

• Coordinate, complete, and update management on clinical quality

• Establish and maintain an action plan to improve HEDIS scores

• Implement process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities

• Manage the HEDIS project to include assignment of nurses, adherence to plan timeline, and vendor oversight for timeliness and quality