Registered Nurse Auditor

Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400+ clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, and other health services. With more than 68,000 caregivers on a mission to help people live the healthiest lives possible, Intermountain is committed to improving community health, and is widely recognized as a leader in transforming healthcare. We strive to be a model health system by taking full clinical and financial accountability for the health of more people, partnering to proactively keep people well, and coordinating and providing the best possible care. At Intermountain, every caregiver helps us fulfill our mission of helping people live the healthiest lives possible. Interested in joining our team? Check out our career website and apply today at https://intermountainhealthcare.org/careers/.

To review medical records retrieved from provider offices and abstract medical information for HEDIS (Health Effectiveness Data Information Set) annual audits. Interprets relevant clinical criteria through review of medical records annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS, CMS, and STARS performance measures. The schedule for the position is flex-seasonal. Mid-January through the end of April we ask a minimum of 28 hours per week. May through December the flexibility is 0-14 hours per week depending on active projects being active.

Work collaboratively with Select Health’s HEDIS Manager, Quality Consultants, and Data Analyst Responsible for performing accurate and comprehensive medical record reviews using a proprietary abstraction tool and software on an assigned laptop Reviewer will perform remote or offsite medical record reviews with charts collected from provider offices, clinics and hospitals for the purpose of obtaining documentation to support the HEDIS project. Records will be retrieved by third party vendor, fax, remote EMR access and/or mail processes Locate and review all assigned medical charts, perform abstraction, mark-up supporting documentation per audit specifications Proven organizational and time management skills including the ability to meet required deadlines. Work with provider offices as needed to schedule/confirm appointments, and follow up on medical record requests Calls members to gather procedural information on when and where the member received are and verify care was received. Reviewer must pass a medical record abstraction test prior to beginning the project and will need to maintain minimum competency throughout the project Frequent interactions with providers, members that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues accurately