RN Medical Record Analyst occupation at Highmark in Parkersburg

Highmark is presently looking of RN Medical Record Analyst on Sun, 14 Jul 2013 00:57:13 GMT. **This position is a WV work from home position, extensive daily travel is required in the Parkersburg, WV territory.** Summary of Responsibilities: This position is responsible for coordinating and conducting the office-site and medical/treatment recordkeeping/documentation evaluations for the office sites of Highmark Practitioners related to NCQA standards, HEDIS and RADV documentation. The...

RN Medical Record Analyst

Location: Parkersburg West Virginia

Description: Highmark is presently looking of RN Medical Record Analyst right now, this occupation will be placed in West Virginia. Further informations about this occupation opportunity kindly read the description below. **This position is a WV work from home position, extensive daily travel is required in the Parkersburg, WV territory.**

Summary of Responsibilities:
This posi! tion is responsible for coordinating and conducting the office-site and medical/treatment recordkeeping/documentation evaluations for the office sites of Highmark Practitioners related to NCQA standards, HEDIS and RADV documentation. The office site and medical/treatment recordkeeping/documentation evaluations are conducted in coordination with quality improvement programs which enables Highmark to achieve and maintain NCQA accreditation, to be competitive with other managed care organizations, and to comply with external regulatory agencies (e.g., NCQA, DOH,CMS, etc.) in order to provide access to affordable, quality health care enabling Highmark members to lead longer, healthier lives. The Network Quality Management Consultant II will develop plans and provide consulting services to Highmark providers in order to facilitate behavior changes needed to improve office site environments and medical/recordkeeping/documentation processes to enable physicians to provide affordab! le, quality health care to ensure Highmark members to live lon! ger, healthier lives. This will be accomplished in collaboration with the physicians and physician office staff, through education sessions, physician/member resources, and quality improvement initiatives.

Minimum Qualifications:

• A Registered Nurse is required.
• Three to five years' experience in Quality Management is preferred.
• Certified Professional Coder (CPT and/or CPT-H) is preferred.
• A Bachelor's degree in business, healthcare administration or health related discipline, or other related field or equivalent training is preferred.

Other qualifications, experience, and skills include:

• Clinical Quality Management/Improvement concepts, techniques, processes, and outcome measures.
• Familiarity with accreditation requirements (e.g, NCQA, DOH, CMS, etc.)
• Previous experience conducting office site and medical /treatment recordkeeping/documentation evaluations.
• Compe! tency and knowledge in appropriate technical and professional areas, keeping up to date with current developments and trends, including thorough knowledge of Highmark's Preventive Health Guidelines.
• Well-developed analytical and problem solving skills with the ability to understand and interpret clinical data.
• Comprehension and evaluation of numerical data, table, charts or graphs, performing calculations, making comparisons and combining quantitative information.
• Knowledge of information systems and comparative databases (i.e., Excel, Access, HC3, CPR, etc.)
• Ability to manage change with demonstrated skill.
• Ability to develop goals, action plans and contingency plans, determine information resource requirements, organize information and resources, and establish and communicate expectations regarding goals, tasks, assignments, and deadlines.
• Strong mentoring skills for team work and interdepartmental communications and t! he ability to interact with all levels of the corporation, physicians, ! physician office staff and other internal or external customers
• Understanding of Highmark's overall business strategy to achieve goals and objectives, and uses Highmark's organizational structure, operations, decision-making channels, planning processes, and financial budgeting/control systems to identify potential problems and opportunities.
• Computer literacy.
• Excellent written and verbal communication skills and professional demeanor.

Highmark is an Affirmative Action/Equal Employment Opportunity (AA/EEO) employer.
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If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Highmark.

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This occupation starts available on: Sun, 14 Jul 2013 00:57:13 GMT

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