Hedis Nurse Resume

Dorothy Palmer

2441 Sweetwood Drive

Aurora, CO80014

(555)-555-5555

[email]

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

Example #2

Objective Seeking a responsible position as a Hedis Nurse in a well reputed hospital or clinic where my experience and knowledge are fully employed.

Career Profile:

• Strong interpersonal, organizational, problem solving, analytic and communication skills.
• Excellent ability to perform on-site medical record reviews.
• Profound ability to communicate significant findings, including potential risk management issues to the quality management lead in a timely manner.
• Extended ability to analyze, interpret and relate the medical data.
• In-depth knowledge of the medical terminology.

Nursing Experience:

Hedis Nurse, 2004 to till date

Roswell Park Cancer Institute, Buffalo, NY

• Collected and analyzed health care data.
• Educated providers and office staff about medical records and clinical standard guidelines.
• Collected, analyzed, and reported initiatives and facility compliance with HEDIS population health measures.
• Requested and reviewed appropriate medical records.

Academic Background

Certified Registered Nurse Practitioner (CRNP), 2004

University of Illinois, Chicago, IL

B.S in Nursing, 2003

Yale University, New Haven, CT