Quality Review Specialist (HEDIS Temporary Position: January 3, 2022-May 13, 2022)

7 days left

Minneapolis, Minnesota
Oct 06, 2021
Jan 25, 2022
Employment Status
Full Time
Health Care that Starts with You!

Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.

UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.


Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.

At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.




UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.


Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.

Our strong culture has established UCare as a Star Tribune Top 150 Workplace for 12 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.


Work Location: Work from home or hybrid (in the office 3 or more days per week)

The health and safety of our employees, members, providers, and our community is our highest priority. Therefore, all new employees are expected to be fully vaccinated against COVID-19 prior to starting at UCare, subject to limited exceptions such as for a sincerely held religious belief or for medical reasons.

UCare is seeking experienced RNs, Health Information (HIS/HIMS), or other Healthcare professionals for HEDIS medical record review. These positions, in conjunction with the internal HEDIS team, will be working at UCare with provider clinics to accurately abstract medical records for the annual HEDIS MY 2021 project January 3rd - May 13th 2022.

Hours throughout the project may fluctuate a small amount, but generally 40 hours per week. Must at a minimum be willing to work 20 hours per week. Work is primarily remote with some need to visit clinics onsite for auditing.

These positions will have primary accountability for reviewing medical records as identified by the internal HEDIS team, investigating and reporting findings for this team. Staff will also work with providers on scheduling and arranging receiving medical records via electronic methods or in some cases onsite.

Position Description

This position is responsible to perform medical record abstraction and the retrieval of clinical medical records to support the annual Healthcare Effectiveness Data and Information Set (HEDIS) process. Build relationships with our clinical provider community to assist with quality improvement initiatives and to build organization knowledge and awareness of best practices that may impact HEDIS data collection.

• Schedule and perform on-site medical record reviews at physician offices.

• Prepare and record chart abstractions into UCare's HEDIS data software tool.

• Assist HEDIS Supervisor with documents needed for annual HEDIS audit process.

• Act as a liaison between UCare Quality Management Department and Clinical Provider Network to help advance and operationalize quality improvement initiatives.

• Provide clinical and health systems knowledge and expertise to UCare staff and leadership to help ensure quality improvement efforts are both impactful to the health plan's HEDIS rates, but also meaningful to the clinical provider community.

• Collaborate with the HEDIS Supervisor to recommend ongoing development and improvements to the HEDIS process and data collection methodologies.

• Conduct and Analyze axillary medical record audits on advanced directives and medical record standards.

• Other duties and projects as assigned.


Bachelor's degree in Nursing with current and unrestricted Minnesota RN license; or Bachelor's degree in a healthcare related field; demonstrated work experience may be considered in leiu of degree.

Required Experience

Three years of clinical experience or two years of Health Information Systems or Electronic Medical Record experience. Experience with medical record auditing, ability to read and interpret medical records and complete accurate data entry. Proficient in Microsoft Office. Ability to problem solve and communication with various levels of our HEDIS (Health Effectiveness Data and Information Set) team and provide network.

Preferred Experience

Familiarity or experience with HEDIS measurement specifications and claims data is preferred. Candidates should be comfortable with reading and interpreting both electronic and handwritten medical records.


The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

JOB POST DATE: 10/05/2021

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