CareNational Medical Management Blog

March Madness is like hiring Medical Management Professionals

Posted by Tom Hasara on Mar 17, 2017 10:53:45 AM

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As the nation once again falls victim to the annual and acute affliction of March Madness, I felt inspired by the many correlations to the hiring process. I know that for some, the hiring process may feel more like a surprise game of dodgeball at an anger management retreat than the elegant brackets of the NCAA tournament. But in the clinical and non-clinical Medical Management niche that CareNational specializes in, it often has the appearance of an intense and culminating competition. By the time the best candidates have moved into the final round of interviews, I am emotionally invested in seeing my favorite win that title; much like the Final Four.  I thought I would look at a few other similarities between the landmark collegiate basketball tournament and the recruiting and hiring process for Managed Care professionals in Case Management, Utilization Management, and Quality Management.

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Topics: Medical Management

Provider Offices and the HEDIS Process

Posted by Tom Hasara on Mar 10, 2017 3:36:50 PM

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With H.E.D.I.S. ( Healthcare Effectiveness Data and Information Set) season well under way, CareNational has been very successful in finding qualified nurses and clerical support staff to fill assignments for our clients related to this critically important Quality Improvement audit. We make it our mission to find quality individuals with the appropriate backgrounds to best suit our clients’ needs. When considering a large-scale project like HEDIS, it is important to recognize that it is really a year-round team effort, that requires the support of both the health plan and the contracted network of providers. This week we asked our resident HEDIS expert to answer a common question:   What are some ways a Managed Care Organization can get providers to understand the importance of HEDIS initiatives occurring year round?  Here is what she had to say:
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Topics: Medical Management, HEDIS, Managed Care, Healthcare Services, Health Care Services

HEDIS & Health Plan Reimbursement

Posted by Tom Hasara on Mar 3, 2017 11:30:19 AM

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 As the 2017 H.E.D.I.S. (Healthcare Effectiveness Data and Information Set) season continues, CareNational is dedicating a series of blogs to help health plans. This segment comes from out talks with La' Chanda Plummer, a highly qualified and experienced HEDIS Program Manager and Quality Improvement leader that we placed at a medium sized health plan in the Pacific Northwest recently. It was her job to see that this growing plan achieved NCQA accreditation and improved HEDIS Scores.  Under her direction, that health plan improved their Medicare Stars Ratings by 1.5 Stars in just 1 season!

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Topics: HEDIS

Journey up the HEDIS Mountain

Posted by Prashant Patel on Feb 3, 2017 1:02:26 PM

Written by Prashant Patel, Associate Regional Director.
Contact him at 1.800.974.4828 x106 or prashant@carenational.com

 

With the 2017 H.E.D.I.S. (Healthcare Effectiveness Data and Information Set) work already started for some and quickly approaching for others, CareNational has been on a quest to find qualified nurses and clerical support staff to fill assignments for our clients related to this critically important Quality Improvement survey. Since we are experts in providing top-tier talent, but not in actually doing Quality Improvement or HEDIS functions, we are tapping into the extensive knowledge of our candidates using an ‘Ask the Expert’ format.

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Topics: Medical Management, HEDIS, Managed Care, Healthcare Services, Health Care Services

Vendors for HEDIS: Production vs Staffing

Posted by Prashant Patel on Jan 27, 2017 2:32:59 PM

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Written by Prashant Patel, Associate Regional Director.
Contact him at 1.800.974.4828 x106 or prashant@carenational.com

As one of the nation’s top HEDIS agencies, CareNational is always committed to providing the finest service possible to our candidates and our clients. This includes continuing education through interactive conversations with contacts from both the client and candidate perspective. As the 2017 H.E.D.I.S. (Healthcare Effectiveness Data and Information Set) season approaches, CareNational is dedicating a series of blogs to help leaders and staff-level workers involved in the HEDIS process.

Get the HEDIS Staffing Vendor Checklist

For many Managed Care Organizations, some pre-HEDIS activities are already underway. Additionally the bulk of the work, Chart Abstraction and Over-Reading, is right around the corner. I wanted to address the substantial role that outside vendors play during the HEDIS season. There are many vendors out there that provide different HEDIS services. Identifying what exactly is needed and who can provide it is paramount, as some vendors are involved in one or more phases of HEDIS: Data Validation, Chart Abstraction, or Over-Reading. Selecting the right vendor to partner with your health plan can make all the difference for having the right people in place, meeting established deadlines, and generally surviving the season with no new ulcers.

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Topics: HEDIS, HEDIS Staffing

I was sent to a Doctor's Office to do a HEDIS Audit

Posted by Aaron Lebovitz on Jan 13, 2017 3:12:16 PM

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Written by Aaron Lebovitz, President
Contact him at 1.800.974.4828 ext 102, or aaron@carenational.com

 

With H.E.D.I.S. (Healthcare Effectiveness Data and Information Set) production work right around the corner, CareNational has been on a quest to find qualified nurses and clerical support staff to fill assignments for our clients related to this critically important Quality Improvement survey. We make it our mission to find quality individuals with the appropriate backgrounds to best suit our clients’ needs. When considering a large-scale project like HEDIS, it is important to recognize the efforts of all of the positions involved that allow the audit to run smoothly. This week we wanted to highlight a topic encountered every year, the dynamic between provider office staff and the clinical or non-clinical HEDIS professional charged with extracting required information for this annual audit.

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Topics: Medical Management, HEDIS, Managed Care, Healthcare Services, Health Care Services

HEDIS Scores & Managed Care Reimbursement

Posted by Tom Hasara on Jan 6, 2017 3:44:17 PM

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As one of the nation’s best HEDIS staffing agencies, CareNational is always committed to providing the best service possible to our candidates and our clients. This includes continuing education through interactive conversations with contacts from both the client and candidate perspective. As the 2017 H.E.D.I.S. (Healthcare Effectiveness Data and Information Set) season approaches, CareNational is dedicating a series of blogs to help health plans. Since we are experts in providing top-tier talent, but not in actually doing Quality Improvement or HEDIS functions, we are tapping into the extensive knowledge of our candidates using an ‘Ask the Expert’ format.

This segment comes from La' Chanda Plummer, a highly qualified and experienced HEDIS Program Manager and Quality Improvement leader that we placed at a medium sized health plan in the Pacific Northwest last year. It was her job to see that this growing plan achieved NCQA accreditation and improved HEDIS Scores.  Under her direction, that health plan improved their Medicare Stars Ratings by 1.5 Stars in just 1 season!

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Topics: HEDIS

HEDIS Abstraction vs HEDIS Over-reading

Posted by Terry Kennedy on Dec 30, 2016 10:18:16 AM

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Written by Terry Kennedy, Senior Search Consultant.
Contact her at 1.800.974.4828 x105, or terry@carenational.com

 

As one of the nation’s premier HEDIS staffing agencies, CareNational is always committed to providing the best service possible to our candidates and our clients. This includes continuing education through interactive conversations with contacts from both the client and candidate perspective. As the 2017 H.E.D.I.S. (Healthcare Effectiveness Data and Information Set) season approaches, CareNational is dedicating a series of blogs to help health plans. Since we are experts in providing top-tier talent, but not in actually doing Quality Improvement or HEDIS functions, we are tapping into the extensive knowledge of our candidates using an ‘Ask the Expert’ format.

I recently spoke with Belinda B. about the difference between HEDIS Abstraction and HEDIS Over-reading. Belinda is a seasoned HEDIS Nurse from Florida, with over 6 years of HEDIS experience in a variety of roles, including HEDIS Abstraction, Over-reading and HEDIS Project Management.

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Topics: HEDIS

How Do I Get Hired for HEDIS If I Have Never Done HEDIS?

Posted by Tom Hasara on Dec 16, 2016 12:14:51 PM

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As one of the nation’s premier HEDIS staffing agencies, CareNational is always committed to providing the best service possible to our candidates and our clients. This includes continuing education through interactive conversations with contacts from both the client and candidate perspective. As the 2017 H.E.D.I.S. (Healthcare Effectiveness Data and Information Set) season approaches, CareNational is dedicating a series of blogs to help health plans. Since we are experts in providing top-tier talent, but not in actually doing Quality Improvement or HEDIS functions, we are tapping into the extensive knowledge of our candidates using an ‘Ask the Expert’ format. 

Since CareNational is a boutique third-party Medical Management recruiting and consulting agency, we are limited to very strict parameters for every search, as outlined by our clients. HEDIS season is no different, as we are tasked by our clients to find the most qualified and experienced nurses for their critical and time-sensitive HEDIS staff positions. The most essential piece of the candidate equation is the experience, particularly for limited-term temporary contract assignments. From time to time, nurses will ask me how they can gain the required HEDIS experience, if they have never worked a HEDIS assignment. To some it may seem like a Catch 22: “I need the experience to get the assignment, but I need the assignment to get the experience.”

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Topics: HEDIS

What if I get a late start on my HEDIS Hiring?

Posted by Tom Hasara on Dec 9, 2016 3:54:12 PM

 

As one of the nation’s best HEDIS staffing agencies, CareNational is always committed to providing the best service possible to our candidates and our clients. This includes continuing education through interactive conversations with contacts from both the client and candidate perspective. As the 2017 H.E.D.I.S. (Healthcare Effectiveness Data and Information Set) season approaches, CareNational is dedicating a series of blogs to help health plans.

Read More

Topics: HEDIS