Updated: Apr 6, 2023 Published Nov 30, 2011
neatnurse30
166 Posts
I recently read a lot about QI/QA on this forum, and this nursing specialty sounds so interesting. I really want to get away from the bedside care nursing. My friend recently got a job with healthcare insurance as a Utilization Review Nurse ( or something like that) and is very happy; she will also get full training. I just saw an ad in my area for Hedis Nurse Reviewer and Utilization Review Nurse; they want acute care experience ( which I do - 6 years of medical-surgical), and Hedi's knowledge is a preferred/big plus. I don't know anything about Hedis and am not sure if they will be willing to train me appropriately. I'm so confused if I should have applied for these jobs. The job of Hedis Nurse Reviewer involves traveling to Md/hospital offices, and I don't understand quite what I would be doing exactly.
Of those of you who work in that field- do you recommend reading certain books or getting specific certifications for these types of jobs? How do I learn Hedis before the job?
rachaelgarn
1 Post
Hi. I am a project manager for a HEDIS project. I see this post is from last month, so I don't know if you got the answers, you are looking for or not. HEDIS is how health insurance companies get accredited. You can visit the NCQA website for more information. It is a quality assurance program. If you are trying to get a very flexible job, HEDIS is it. Our company (as do most of our kind) does a complete training, all you need to know is how to read charts, medical terminology and such. This is why we generally prefer nurses. You go out to the doctor's office and look through the charts that they pulled for you and find the data.
desertflower100
39 Posts
You should apply. I just got hired with no HEDIS experience; hurry, though, HEDIS season is starting very soon.
dustar
Hi good day everyone!
I wanna ask how can I get HEDIS training. I want to take this opportunity. I don't know where I can get this kind of training. Thank you for your time.
titilayo10
Hi, I also need information on where I can get Hedi's training in MD. I applied to a lot of places but I was told I needed to have the knowledge.
Errin1
3 Posts
Same here. I am a LPN with 23 yrs of experience, and I need a change. I think I'm done with hands-on nursing and would love to get into chart review or HEDIS in NY, and I have no idea how to do it. I called to execute a search, and they weren't helpful. All they said was you need experience, but HOW does one go about getting the experience? I know projects have already started, but I really want someone to advise me on how to get my foot in the door. Please be specific; a lot of the advice on these boards has been vague at best.
zahryia, LPN
537 Posts
Quote Same here. I am a LPN with 23 yrs of experience, and I need a change. I think I'm done with hands-on nursing and would love to get into chart review or HEDIS in NY, and I have no idea how to do it. I called to execute a search, and they weren't helpful. All they said was you need experience, but HOW does one go about getting the experience? I know projects have already started, but I really want someone to advise me on how to get my foot in the door. Please be specific; a lot of the advice on these boards has been vague at best.
Get a job where you have to abstract information from medical records. If you're already to do this in your position, highlight that you are doing it in some capacity.
That's basically all HEDIS is.
The next thing to do is to go on the NCQA website and look at the HEDIS measures so that you're familiar with them. You want to focus on the hybrid measures.
We are pretty late in the HEDIS season, so one of two things can happen: either all of the jobs will have dried up, or if they're still looking, they might be desperate enough to consider someone who doesn't have any experience but understands the concept.
Also, I would imagine that HEDIS jobs are popular in cities where there are a lot of PCPs, so if you live in a rural town, I don't think there will be a lot of positions.
Check out multiple nursing agencies. These are typically temporary and or contractual positions.
So, if one agency says no, move on to the next.
Check Indeed and Craigslist.
sjames0402
I start a new position tomorrow as Hedi's abstractor. Kind of nervous. I do have experience with chart review.
How's it going with the new job?
Ngwizzy
Please give me a link to your site where I can apply. Thank you.
JoAnnS
139 Posts
TESG's HEDIS/QARR Training Program â€" Apply Today!
This company is training for $150.00. I want to get trained for free.
Diane1954
2 Posts
I looked on the website seems to be only in New York. Also, it does say they will reimburse you when hired.