Hedis Nurse Resume
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2441 Sweetwood Drive
Aurora, CO80014
(123)-486-7121
d.palmer@emailaddress.com
Job Objective: Inspiring Hedis Nurse wishes to obtain a career with an established hospital looking for loyal employees who are dedicated to their hospital.
Summary of Qualifications:
Ability to collected from medical records, immunization registries, member documents and provider office
Excellent interpersonal and organizational skills
Effective problem solving, analytic and communication skills
Professional phone etiquette
Amazing ability to demonstrate appreciation of cultural diversity and sensitivity towards target population
Remarkable ability to work calmly and effectively under adverse conditions
Work Experience:
Hedis Nurse, August 2005 - Present
Amerigroup, Aurora, CO
Educated provider and office staff about medical records and clinical standard guidelines.
Assisted in defining opportunities for improvement through analysis of patterns and trends.
Communicated significant findings, including potential risk management issues to the Quality Management.
Performed on-site medical record reviews.
Adhered to established procedures for scheduling, requesting, and reviewing records while on-site at provider offices and hospitals.
Hedis Nurse, May 2000 – July 2005
CareSource, Aurora, CO
Collected, researched and organized information to use in reviews.
Reported reviews not meeting criteria to peer consultants, including medical directors.
Maintained complete confidentiality of protected health information.
Communicated with management regarding development within areas of assigned responsibilities.
Gathered, entered, and analyzed data.
Performed Medical Reviews in Physicians offices throughout the state.
Education:
Bachelor of Science in Nursing Practitioner, Central Pennsylvania College, Summerdale, PA