Hedis Nurse Resume Sample
Irving Heathcote
629 Schumm Freeway,
Houston,
TX
+1 (555) 408 5871
Work Experience
RN Hedis Nurse Team Lead
12/2016
-
PRESENT
Phoenix, AZ
- Provider / Hospital follow up requested medical records required
- Collect member records and conduct reviews of records by contacting providers and placing the results collected into a specific data base
- Participate in staff meetings and project updates to maintain expert level of proficiency in HEDIS/MRR software system function and reporting
- Participates in all HEDIS/MRR abstraction training regarding specification standards including annual updates
- Establish and maintain positive and effective work relationships with coworkers, clients and management
- Strong data entry and computer navigation skills
- Proficient with PC-based systems and the ability to learn new information system and software programs
- Detail and process oriented with focus on efficiency
Hedis Nurse
10/2012
-
08/2016
Houston, TX
- Analyze, develop and implement improvement activities to increase compliance rates as measured by nationally standardized benchmarks and definitions
- Perform oversight activities on entities with Plan delegated functions, regularly audit entities with Plan delegated function, develop, implement, and follow up with corrective action plans
- Responsible for entering data into a HEDIS software system
- Current valid driver’s license and reliable transportation are required for project participation
- Attends HEDIS Medical Record Review Abstraction Training
- Attends HEDIS Software Training
- Receives HEDIS assignment and independently contacts offices, schedules appointments, arranges to get appropriate material to the offices on a timely basis
Hedis Nurse Reviewer
09/2007
-
09/2012
San Francisco, CA
- Collects necessary medical record information through office visits or faxes and enter into the HEDIS Software
- Complete assignment within specified time frames
- Follows up on missing clinical information
- Attends Post Mortem and provides suggestions for the following years Medical Record Review
- RN, LPN, LVN
- Case Management, Utilization Review Experience
- Prior experience working on a HEDIS audit
- RN or LPN license from any state
- Able to navigate CPT4 code and ICD9 DX based on HEDIS
Education
Upper Iowa University - Waterloo Center
2003 - 2007
Bachelor's Degree in Management
Professional Skills
- Experience working in various EMR systems and strong computer skills
- Prior chart review or relevant clinical experience involving medical record documentation or medical claims experience
- Proven medical skills and knowledge
- Experience in Medical Record Review, Data Abstraction, Quality Management, GPRO or HEDIS; 1+ year of Medical-Surgical Clinical Nursing experience
- Prior Chart Review or relevant Clinical experience involving Medical Record Documentation or Medical Claims
- Recent experience with HEDIS Medical Record abstraction and data entry
- Active Licensed Practical Nurse with medical record chart review, quality, performance improvement, case management, or Informatics experience
How to write Hedis Nurse Resume
Hedis Nurse role is responsible for travel, research, reporting, auditing, database, training, software, reliability, transportation, health.
To write great resume for hedis nurse job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Hedis Nurse Resume
The section contact information is important in your hedis nurse resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Hedis Nurse Resume
The section work experience is an essential part of your hedis nurse resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous hedis nurse responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular hedis nurse position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Hedis Nurse resume experience can include:
- Experience in Medical Review (Utilization Review, Case Manager, Audit, HEDIS, etc.)
- Experience with certified HEDIS software desirable
- Working knowledge of different EMR systems
- Active Registered Nurse of Practical Nurse license
- Active New Jersey Registered Nurse license
- Active Registered of Practical Nurse license
Education on a Hedis Nurse Resume
Make sure to make education a priority on your hedis nurse resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your hedis nurse experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Hedis Nurse Resume
When listing skills on your hedis nurse resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical hedis nurse skills:
- Solid medical record review experience (Utilization Review, Case management, Chart audit, etc)
- Active Registered Nurse with medical record chart review, quality, performance improvement, case management, or Informatics experience
- : Registered Nurse with clinical experience
- Personal computer experience, preferably with Windows software
- Experience with Med Assurant Software desirable
- Experience with chart review (medical review, audit, case manager, Utilization Review, etc.)
List of Typical Skills For a Hedis Nurse Resume
1
Skills For Hedis Review Nurse Resume
- NJ Licensed Practical Nurse (LPN)
- Active Florida State Registered, Practical, or Vocational Nurse license
- Active Tennessee State Registered, Practical, or Vocational Nurse license
- AZ licensed Registered Nurse (RN), Licensed Practical Nurse (LPN) and/or Licensed Vocational Nurse (LVN)
- Active Georgia State Registered, Practical, or Vocational Nurse license
- Active New York State Registered or Practical Nurse license
- Able to navigate Microsoft Office - Word and Excel
2
Skills For Hedis Nurse Reviewer Resume
- R.N./LPN Licensure in Connecticut
- Knowledge of Electronic Medical Record systems desirable
- : Registered Nurse or Certified Medical Coder
- Registered Nurse or Vocational Nurse - Texas (active, no restrictions)
- Research and detail-oriented
Related to Hedis Nurse Resume Samples
Hospice Nurse Resume Sample
Work Experience
• Identify actual or potential quality/safety/ethical/legal/compliance issues and initiates appropriate intervention or referral. Updates the attending physician/IDT about changes in the patient’s condition and/or plan of care
• Demonstrate and communicate the core values of BAYADA Hospice and The BA...
Professional Skills
• Demonstrates technical competency, critica...
• Strong IV / Critical Care knowledge and ex...
• Effective oral/written communication, cust...
MDS Nurse Resume Sample
Work Experience
• Facilitates accurate determination of the MDS-HC that accurately reflects the patient's care needs and captures all resources utilized to ensure accurate representation of the member’s clinical and functional needs
• Assures the completion of the MDS-HC assessment through documentation review o...
Professional Skills
• Excellent attention to detail; well organized
• Valid CPR verification
• Provide one-on-one or small group educatio...
Pacu Nurse Resume Sample
Work Experience
• Assists with staffing issues, medication administration, airway management, monitors vital signs, pain control, drain patency, cast care, CMS checks, neurological evaluation, care of invasive lines and updating Physician as needed with changes in patient status
• Participates in at least one commun...
Professional Skills
• Prior PACU experience
• Prior Preop, PACU or critical care experience
• Demonstrates proper airway management tech...
Care Nurse Resume Sample
Work Experience
• Ensures that services provided to eligible members are within benefit plan and appropriate contracted providers are being utilized
• Determines appropriate utilization management of services requested
• Assists with implementation of healthcare initiatives in market
&nb...
Professional Skills
• Strong clinical skills, including an under...
• Maintains clinical skills by reviewing rel...
• Effective communication skills including b...
Nurse, Rn Resume Sample
Work Experience
• Determine member’s discharge status and identify and coordinate any additional needs and service that require ongoing Care Coordination services
• Recent (recent within the past 3-5 years) clinical experience in a hospital, LTAC, Rehab, SNF setting evaluating hospital benefit determination, medical...
Professional Skills
• Strong interpersonal, oral and written com...
• Demonstrate a proficiency in computer skil...
• Demonstrated critical thinking skills, abi...
Surgery Nurse Resume Sample
Work Experience
• Reviews laboratory data for abnormal or unusual results
• Work closely with the medical, nursing, and ancillary staff of the institution to provide quality and safe care. Continuity between ACC, CDU and specialty services is emphasized
• Assesses and assists with patient’s di...
Professional Skills
• Prior experience working in an Ambulatory ...
• Prior experience working in an ambulatory ...
• Recent Ambulatory Surgery experience; 2+ y...