HEDIS Per Diem Nurse Reviewer Job at Blue Cross & Blue Shield of Rhode Island
Blue Cross & Blue Shield of Rhode Island Providence, RI 02903
Please email hr_business_partners@bcbsri.org if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
Jump into the new world of health insurance:
At Blue Cross & Blue Shield of Rhode Island (BCBSRI), our business is healthcare. But our focus is on improving lives. Be part of a team that is large enough to make a difference but small enough to be innovative. Work in a rapidly changing field. Take a chance to be creative. Move outside the status quo. Shape new ideas with the power of a national brand behind you.
Join others who know diversity is strength:
We appreciate and celebrate everything that makes us unique: age, national origin, citizenship status, perspectives, experiences, physical or mental disability, military status, race, ethnicity, religion, gender, sexual orientation, gender identity and/or expression. Our diversity strengthens us as an organization and helps us better serve an increasingly diverse Rhode Island population.
Why this job matters:
Coordinate medical record-related tasks for Healthcare Effectiveness Data Information Set (HEDIS). Perform a variety of assignments to support team members and leaders. Collaborate with team members to ensure that all medical record reviews are accurately completed and meet intended quality.
What you will do:
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
Blue Cross & Blue Shield of Rhode Island has a COVID-19 vaccination requirement for all associates. Offers of employment are contingent on being fully vaccinated for COVID-19 or through an approved accommodation request for either a medical or religious exemption. Requests for accommodations can be made to a representative in the human resources department upon receiving an offer.
At Blue Cross & Blue Shield of Rhode Island (BCBSRI), diversity and inclusion are central to our core values and strengthen our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity, affirmative action employer. We provide equal opportunities without regard to race, color, religion, gender, age, national origin, disability, veteran status, sexual orientation, genetic information and gender identity or expression.
The law requires an employer to post notices describing the Federal laws prohibiting job discrimination based on race, color, sex, national origin, religion, age, equal pay, disability, veteran status, sexual orientation, and genetic information and gender identity or expression. Please visit https://www.eeoc.gov/employers/eeo-law-poster to view the "EEO is the Law" poster.
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Jump into the new world of health insurance:
At Blue Cross & Blue Shield of Rhode Island (BCBSRI), our business is healthcare. But our focus is on improving lives. Be part of a team that is large enough to make a difference but small enough to be innovative. Work in a rapidly changing field. Take a chance to be creative. Move outside the status quo. Shape new ideas with the power of a national brand behind you.
Join others who know diversity is strength:
We appreciate and celebrate everything that makes us unique: age, national origin, citizenship status, perspectives, experiences, physical or mental disability, military status, race, ethnicity, religion, gender, sexual orientation, gender identity and/or expression. Our diversity strengthens us as an organization and helps us better serve an increasingly diverse Rhode Island population.
Why this job matters:
Coordinate medical record-related tasks for Healthcare Effectiveness Data Information Set (HEDIS). Perform a variety of assignments to support team members and leaders. Collaborate with team members to ensure that all medical record reviews are accurately completed and meet intended quality.
What you will do:
- Conduct provider site visits and medical record reviews annually for HEDIS and as needed to audit the population health registry tool
- Coordinate project-related tasks for HEDIS activities across the organization.
- Review HEDIS deliverables; support HEDIS Manager to ensure all deliverables are accurately completed and meet intended quality.
- Perform testing on population health registry tool.
- Prepare documentation, data, and reports for management.
- Utilize various data and information systems supporting these activities. Work with technical staff on maintenance of data, and the utilization of various systems to maximize the clinical and business benefits of effective information management.
- Assist team with department initiatives and projects.
- Perform other duties as assigned.
- Associates degree; or an equivalent combination of education and applicable work experience
- Two to four years of experience in conducting medical record review audit
- Experience in the health insurance industry
- Project coordination experience
- Knowledge of project management methodologies
- Proficiency with Microsoft Suite of products; i.e., Word, Excel, PPT, etc
- Working knowledge of Microsoft Office including Excel, and Word
- General computer proficiency
- Written and verbal communications skills
- Good organization skills
- Time management skills
- Detail oriented
- Ability to research and organize data
- Ability to organize work efficiently to meet established time and quality standards
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
- In-office: onsite 5 days per week
- Hybrid: onsite 2-4 days per week
- Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Connecticut, Massachusetts, Rhode Island, Arizona, Florida, Georgia, Louisiana, North Carolina, Oklahoma, South Carolina, Texas, Virginia
Blue Cross & Blue Shield of Rhode Island has a COVID-19 vaccination requirement for all associates. Offers of employment are contingent on being fully vaccinated for COVID-19 or through an approved accommodation request for either a medical or religious exemption. Requests for accommodations can be made to a representative in the human resources department upon receiving an offer.
At Blue Cross & Blue Shield of Rhode Island (BCBSRI), diversity and inclusion are central to our core values and strengthen our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity, affirmative action employer. We provide equal opportunities without regard to race, color, religion, gender, age, national origin, disability, veteran status, sexual orientation, genetic information and gender identity or expression.
The law requires an employer to post notices describing the Federal laws prohibiting job discrimination based on race, color, sex, national origin, religion, age, equal pay, disability, veteran status, sexual orientation, and genetic information and gender identity or expression. Please visit https://www.eeoc.gov/employers/eeo-law-poster to view the "EEO is the Law" poster.
Please Note :
bankofmontserrat.ms is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, bankofmontserrat.ms provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.