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Hedis Remote Chart Review information

What is a HEDIS remote chart reviewer?

A HEDIS Remote Chart Reviewer is a healthcare professional who reviews medical records from a remote location to collect data for the Healthcare Effectiveness Data and Information Set (HEDIS). This data is used by health plans to measure performance on important dimensions of care and service. Reviewers look for specific information in patient charts to ensure health plans meet quality standards and regulatory requirements. The job typically requires experience in medical record abstraction, knowledge of HEDIS measures, and strong attention to detail.

What are the key skills and qualifications needed to thrive as a HEDIS remote chart reviewer?

To thrive as a HEDIS Remote Chart Reviewer, you need a solid understanding of medical terminology, healthcare coding (ICD-10, CPT), and HEDIS measures, often supported by a clinical background such as nursing or health information management. Proficiency with electronic medical records (EMRs), chart abstraction tools, and secure remote work platforms is typical, and experience with HEDIS-specific software is highly valued. Attention to detail, time management, and strong written communication are crucial soft skills for ensuring accurate data extraction and reporting. These competencies ensure high-quality, compliant chart reviews that contribute to healthcare quality initiatives and regulatory reporting.

What are some common challenges faced by professionals in a HEDIS remote chart review role, and how can they be addressed?

Professionals in HEDIS Remote Chart Review often encounter challenges such as inconsistent documentation in medical records, navigating various electronic health record (EHR) systems, and ensuring data accuracy while working independently. Addressing these challenges involves developing strong attention to detail, leveraging organizational tools to track reviewed charts, and maintaining open communication with team leads and colleagues for clarification or support. Regular training on EHR systems and HEDIS measures can also help reviewers stay current and efficient in their work.

What is the difference between Hedis Remote Chart Review vs Medical Records Reviewer?

AspectHedis Remote Chart ReviewMedical Records Reviewer
CredentialsTypically requires nursing or healthcare-related certificationsOften requires medical or healthcare background, certifications vary
Work EnvironmentRemote, independent review of patient chartsRemote or onsite review of medical records
Industry UsageUsed mainly in healthcare quality and compliance programsUsed across healthcare, insurance, and legal sectors

Hedis Remote Chart Review and Medical Records Reviewer roles both involve reviewing medical records remotely, often requiring healthcare certifications. However, Hedis reviews focus specifically on healthcare quality metrics for Medicaid and Medicare, while Medical Records Reviewers may work in broader contexts like insurance claims or legal cases. Both roles demand attention to detail and healthcare knowledge, but Hedis reviews are more specialized in compliance and quality measurement.

What are popular job titles related to Hedis Remote Chart Review jobs in Colorado?

For Hedis Remote Chart Review jobs in Colorado, the most frequently searched job titles are:

What job categories do people searching Hedis Remote Chart Review jobs in Colorado look for?

The top searched job categories for Hedis Remote Chart Review jobs in Colorado are:

What cities in Colorado are hiring for Hedis Remote Chart Review jobs?

Cities in Colorado with the most Hedis Remote Chart Review job openings:

Hedis Remote Chart Review jobs near you

Physician VC3 (Virtual Care for Chronic Conditions)

Denver, CO • On-site, Remote

Colorado Permanente Medical Group
Health Care and Social Assistance • 1 - 5K employees
Learn more about Colorado Permanente Medical Groupexternal

$323K/yr

Part-time

Medical, Dental, Life, Retirement, PTO

Re-posted 7 days ago

Job description

Colorado Permanente Medical Group is seeking board certified or board eligible Family Medicine or Internal Medicine physicians who are interested in doing virtual work for our members.
This position does require the physician to be a Colorado resident and or willing to relocate to Colorado. This is an employed and benefited position.
Open to part time and full-time interest.
Employment Requirement: Colorado Permanente Medical Group, P.C. staff must be fully vaccinated against COVID-19 or have established a qualified medical or religious, exemption by September 17, 2021. All persons offered a position will be required to provide valid proof of vaccination or qualifying exemption prior to starting employment.
Job Summary:
The VC3 (Virtual Care for Chronic Conditions) Physician will work to ensure quality care for identified KPCO adult members by utilizing virtual visits through approved technologies to address chronic conditions and close care gaps in a patient-centered manner. VC3 providers will support members who have unaddressed chronic conditions or open care gaps via the conduct of virtual wellness visits. Whenever possible, they will preview, update, and modify the health record in HealthConnect (EPIC) to optimize the chart for their virtual encounters and perform PC3 (Patient Centered Charting and Communication) chart reviews between virtual visits. The work completed by the VC3 Physicians will be monitored through proficiency metrics and chart audits to ensure quality documentation. VC3 Physicians will report to the VC3 Physician Lead who reports to the Medical Director of Documentation Education.
Major Responsibilities:
  • VC3 Physicians will:
    • Conduct on-demand virtual visits for adult members in conjunction with existing Specialty Care encounters or when the patient is onsite for other care needs. They may also be scheduled for virtual visits in conjunction with the Wellness Care Team. As such, VC3 Physicians will be expected to be available during normal clinic hours Monday through Friday. Between VC3 virtual visits, chart reviews will be conducted to ensure completeness and accuracy of the medical record. These will be done according to PC3 Physician Reviewer standards. This dedicated FTE must be an increase over their currently benefitted FTE and may not exceed a total FTE of 1.0. Any request to decrease clinical FTE to take on this role would require approval by Primary Care leadership (clinic Medical Director).
    • Be fluent with care gap closure and the T.O.F.U. (Treatment or Observation or Follow Up) supporting documentation standard and maintain T.O.F.U., Chronic Disease State Management (CDSM) address rates, and Care Gap closure statistics measured by the Provider Opportunity Report (POR) above the quality goals set by the organization. If VC3 Physicians are not meeting these expectations even after remediation and coaching, they will be released from the position. Documentation will be monitored by the Patient Centered Charting and Communication (PC3) team, the VC3 Physician Lead, and by the Medical Director of Documentation Education. In-person or virtual check-in meetings will occur on a regular basis to provide ongoing feedback.
    • Be able to work in a fast-paced care setting requiring the ability to manage multiple competing demands, constantly re-prioritize, and succinctly communicate relevant information effectively to both patients and medical team members.
    • Provide expert integrated care and diagnostic services in a non-clinic setting, through the use of virtual and remote technologies.
    • Work remotely as long as the remote internet connection is secure, and bandwidth is sufficient to manage the virtual appointments. When a remote connection is not sufficient, physicians will work from other KP facilities.
    • Develop expertise in virtual platforms and standards for caring for our members remotely as well as Colorado's care venues and their respective capabilities.
    • Work closely with Primary Care, Specialty Care, Message Management, and the Wellness Care Team to improve care coordination for our members.
    • Perform PC3 chart reviews between virtual visits according to PC3 standards by reviewing multiple sections of the medical record and updating appropriately, using clinical judgement to add, resolve, delete chronic conditions from the Problem List and/or CDSM Best Practice Advisory (BPA), consolidate/refine diagnoses as needed, updating overview notes with relevant supporting clinical information, and prioritizing the Problem List according to PC3 guidelines.
    • Maintain flexibility in staffing to ensure coverage for the VC3 department, including working to arrange vacation/PTO in order to coordinate with other VC3 providers to maintain adequate coverage.
    • Maintain an appropriate work from home environment including professional background, quiet space from which to work without distractions, and privacy to ensure patient confidentiality.
    • Work effectively in an inter-disciplinary team collaborating with care teams to explore patient health conditions and diagnose health issues, while ensuring positive, effective patient experiences. They will maintain knowledge of cultural competency, particularly related to how variables related to socioeconomic status, race, ethnicity, and culture impact physical and emotional health.

Benefits
CPMG offers a Market-leading benefit package, which includes:
  • Medical and dental coverage
  • Life insurance
  • Short-term and long-term disability coverage
  • Professional liability coverage (occurrence-based)
  • 401(k) and Defined Benefit Retirement Plan (Cash Balance)
  • Vacation, holidays, sick leave and educational leave with funds
  • Pay range: minimum $323,904.00 (Family Medicine) & $333,714.00 (Internal Medicine) *Salary will be based on years of experience and FTE.

Our Mission
Colorado Permanente Medical Group (CPMG) has an exclusive, integrated partnership with Kaiser Foundation Health Plan of Colorado. While we are separate organizations complementing one another, our missions are the same--to provide high-quality, affordable health care services and improve the health of our members and the communities we serve.
By offering care and coverage together, we help Coloradans thrive. We serve communities throughout Denver/Boulder, Northern and Southern Colorado.
Our Culture
As a CPMG physician, you'll find fulfillment working alongside board-certified colleagues in a comprehensive array of specialties. Permanente Medicine allows you to practice evidence-based, patient-centered medicine in a culture that is collaborative, inclusive and committed to making a difference in people's lives.
Our system combines quality resources, state-of-the-art facilities, an Epic-based electronic medical records system, and true experts who collaborate. Free from the pressures of practicing fee for service medicine, you can focus on what matters most--caring for your patients.
Partnering closely with our physicians, CPMG professional staff use their expertise in business operations management, scheduling, analytics, human resources, communications, legal, finance and strategy to support high-quality care delivery.
Our team-based culture fosters a respectful and collegial environment where all people are treated with compassion.
Our Inclusive Workforce
Colorado Permanente Medical Group (CPMG) is committed to an inclusive workforce culture. CPMG has a focus on supporting all our physicians and professional staff in an inclusive environment, identifying community healthcare disparities, and providing education and tools in order to provide culturally responsive care in order to mitigate these disparities. If you have an interest in joining our inclusive workforce culture, we encourage you to apply and become a part of our mission to improve the health of our members and communities that we serve.
All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status, marital status, physical or mental disability, age or any other protected status under federal, state or local law.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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