Quality Clinical Management Analyst

  • Location

    Raleigh, United States

  • Sector:

    Other Area(s)

  • Job type:


  • Contact:

    Leric Arcigal

  • Job ref:


  • Published:

    12 months ago

  • Expiry date:


This Req is to support the National Remote Team (NRT)

This is a REMOTE position and candidate could be WAH (anywhere on the East Coast of Central Time zone). Please specify on the resume the located city, state the candidate resides in. If remote candidates are submitted across multiple reqs, please inform MSP Alison Cole. Remote Candidates:

Must have reliable internet connection and experience working in a remote setting Ability to travel to provider offices to collect and/or abstract medical records as needed

The Healthcare Effectiveness Data and information Set(HEDIS) Nurse Abstractor works under the direction of the HEDIS Clinical Measurement and Improvement Lead and other Cigna personnel to collect and review medical records. The HEDIS Nurse Abstractor will abstract pertinent medical record data and enter it into a specified data base to support HEDIS reporting.Daily Activities include review and abstraction of medical records, electronic data entry into project specific computer software, and telephonic outreach to provider offices and vendors to collect medical records. Candidate must be able to work in a fast paced environment and adhere to measured productivity and accuracy requirements. The candidate is required to attain a score of 100% on specific measure testing prior to conducting live medical record reviews and to achieve and maintain a quality reliability score of 95% to remain eligible for employment for the duration of the project. Other duties required can include, but are not limited to, extraction of medical records from electronic storage devices, faxing, scanning, electronic filing, internet and other research activities using Cigna proprietary systems, and telephonic outreach.


Follow established procedures for conductingchart abstractions Extracts electronic medical record data using multiple systems Enters pertinent data from medical records into database as required by established abstraction procedures Communicates effectively and professionally with provider offices and vendors Meet or exceed productivity and accuracy requirements Other duties as assigned by Market Lead, Regional Lead, or Regional Manager