HEDIS RN (Medical Abstractor)
San Francisco Health Plan - San Francisco, CA

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POSITION TITLE: HEDIS Medical Record Abstractor

DEPARTMENT: Health Improvement

FLSA STATUS: Non - Exempt, 1099

REPORTS TO: Director, Health Improvement

SUPERVISES: none

EVALUATION DATE: 11/2012

1099 contract position from January 14, 2013-

May 15, 2013

The San Francisco Health Plan (SFHP) is seeking two energetic and technologically-savvy nurses, nurse practitioners, medical assistants or nursing students to help measure the quality of preventive and chronic care services SFHP members receive. The primary responsibilities of these positions are conducting medical record reviews to identify whether SFHP members received necessary services per national clinical guidelines and entering data into a database. Some of the services include diabetes tests, immunizations, and annual visits.

The abstractors will work in the field (clinics, provider offices and hospitals with which SFHP is contracted) part of the time and in the office part of the time. HEDIS ( Healthcare Effectiveness Data and Information Set) training will be provided. The candidate should be able to work 35-40 hours per week from January 14, 2013 to May 15, 2013.

ESSENTIAL DUTIES & RESPONSIBILITIES

Performs medical record abstraction and enters findings into HEDIS database

Calls provider offices and hospitals to request medical records

Calls members to identify date and provider of HEDIS service

Integrates data collected from a variety of electronic and paper sources including, but not limited to, medical records and immunization registries

Communicates significant findings, including potential risk management issues, to the Health Improvement Department in a timely manner

Provides written evaluation of data collection and data entry processes with ideas for improvement

CORE COMPETENCIES / KNOWLEDGE & SKILL REQUIREMENTS

Strong time management, project management, and organization skills

Ability to:
Produce accurate and precise work.

Find and fix problems.

Work independently and as part of a team.

Manage projects, develop work plans, prepare budgets.

Hold self and others accountable to deadlines.

Problem-solving skills with the ability to formulate and communicate recommendations for improvement both within SFHP and in our provider network.

Strong verbal communication skills, for effective work with SFHP staff, management, and executives; and with health care providers and practice staff.

Strong written communication skills, for powerful succinct messages for busy people within SFHP and provider network. Editing and proofreading skills.

Preferred: familiarity with the Model for Improvement, health care, managed care terminology, Medi-Cal.

EDUCATION, EXPERIENCE & TRAINING REQUIRED

Candidates must be proficient with databases and with conducting 100% of work activities on the computer

Medical background (RN, NP, LVN, MA or RN student)

ESSENTIAL FUNCTIONS – PHYSICAL POSITION REQUIREMENTS; MACHINES AND/OR EQUIPMENT USED

PC literacy required; MSOffice skills (Outlook, Word, Excel, PowerPoint)

Regularly required to operate standard office equipment (personal computer, photocopy machine, fax machine, etc.)

Ability to work on a computer up to 7 hours a day.

Regularly required to sit for long periods of time, occasionally stand and walk.

Regularly required to use hands to operate computer and other office equipment.

Close vision required for computer usage.

Occasionally required to stoop, kneel, climb and lift up to 25 pounds.

WORKING CONDITIONS

Standard office environment without unpleasant or hazardous conditions. Work entails typical physical demands involved in office work. May require occasional weekend and/or evening work.

NOTE: This description is not intended to be construed as an exhaustive list of duties, responsibilities or requirements for the position. This position may change or assume additional duties at any time. The employee may be requested to perform different or additional duties as assigned.

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