Position Overview: This position supports clinical performance improvement through medical record review and data validation audits aligned with Medicare, Medicaid and Commercial quality programs. This position will develop and implement prospective and retrospective medical record review strategies to maximize CMS Star, NCQA HEDIS, and CCO QIM ratings. This position will also be responsible for training temporary staff to complete annual projects within timelines.
Work Experience: Acute care, primary care clinic or medical management experience preferred. Experience using or viewing electronic medical records. Experience performing chart audits.
Education, Certificates, Licenses: Valid Oregon nursing license or other clinical licensure required.
Knowledge: Valid Oregon nursing license or other clinical licensure required.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Physical Requirements: Ability to lift and carry and a laptop and case weighing approximately 15 lbs. Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.