HEDIS Nurse Job Description

hedis nurse job description includes a detailed overview of the key requirements, duties, responsibilities, and skills for this role.

Last update : July 14, 2023

HEDIS Nurse Job Description

HEDIS is a clinical quality measure used by managed care organizations to measure the quality of patient care.

HEDIS is a method by which the quality of care is audited, scored, and reported on.

The HEDIS measures were developed by the National Committee for Quality Assurance (NCQA), a non-governmental organization, and used by all private health maintenance organizations in the United States.

These measures are also used by Medicare to monitor quality of care.

HEDIS measures are based on 10 key measures used to determine the quality of health care.

Key measures are:

Job Brief:

We’re looking for a HEDIS Nurse to help us improve our quality of care. The HEDIS Nurse will be responsible for collecting data and working with our care team to ensure that our patients receive the best possible care.

HEDIS Nurse Duties:

  • Maintain accurate patient records, preparing them to be input into the electronic health record (EHR) system
  • Provide timely, accurate, and confidential medical record documentation
  • Perform clinical charting for a variety of purposes and situations
  • Serve as a liaison between the medical staff and the office, including scheduling, billing, and collection
  • Actively participate in the development of quality, safety, and process improvement plans
  • Educate staff and patients
  • Work collaboratively and communicate with physicians, other health care providers, staff, and patients
  • Provide accurate and timely reports, identifying areas needing improvement

HEDIS Nurse Responsibilities:

  • Registered nurse with 2+ years of experience
  • required minimum of 2 years hospital experience
  • knowledge of medical terminology
  • must have excellent communication skills
  • must possess identified drug allergies
  • must have current CPR certification

Requirements And Skills:

  • Review all medical records and validate the data, including collecting patient demographics, family information, and insurance information
  • Perform HEDIS (Health Effectiveness Data and Information Set) reviews and prepare reports
  • Conduct interviews with patients to obtain information in order to generate HEDIS reports
  • Provide feedback to physicians and team members on HEDIS results
  • Attend team meetings to discuss HEDIS goals, track progress, and provide feedback
  • Coordinate with other team members, including providers, receptionists, and medical assistants

At Company Name, we believe that diversity is key to a successful business. We are committed to building an inclusive team that represents a variety of backgrounds, perspectives, and skills. We encourage applications from people of all races, religions, national origins, genders, , , gender expressions, and ages.

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