Job Title: RN Review Project Manager
Date Posted: 12-27-2006
Job Location: Michigan-Lansing
Job Type: Full Time
Education Level: Bachelors Degree
Work Experience: 2+ to 5 Years
Job Shift: First Shift
Yearly Salary:DOE (Depend on Experience)
Company Name: Medical Reliance Group, LLC
Company Website:
Contact Information: Medical Reliance Gro   Medical Reliance Gro (
Job Description:
Medical Site Reviewers, a national provider of comprehensive, onsite medical facility, medical
record and HEDIS chart review services, is seeking an RN Review Project Manager who will have
direct management oversight of nurse chart review staff; serve as the HEDIS and clinical
resource to support HEDIS project teams, and hold responsibility for all chart review
accuracy, quality, and counseling. 

Responsibilities include: 

 Monitor the regulatory standards/guidelines to accurately conduct and perform reviews for
credentialing, HEDIS and quality improvement studies.

 Monitor and evaluate the quality of Credentialing, HEDIS and custom review abstractions
performed by both field and in-house reviewers. Develop and implement appropriate corrective
action as needed.

 Manage office-based nurse chart review personnel.

 Serve as primary Credentialing, HEDIS and custom review technical resource (i.e., chart
review questions) for review staff.

 Develop training to reflect annual Credentialing, HEDIS and custom review standard process

 Lead review staff training regarding Credentialing, HEDIS and custom chart review

 Assist in the hiring process through evaluation of the clinical experience and background of
the prospective review personnel.

 Coordinate anticipated chart review volume, in-office reviewer capacity, and overall
progress and performance against plans.

 Prepare schedules of coverage for clinical review personnel.

 Maintain open lines of communication of information to management regarding progress and
performance of additional staff.

 Lead follow-up and feedback processes following Credentialing, HEDIS and custom reviews;
make recommendations for process and technical changes, and document changes to custom review
training materials.

 Serve as a Credentialing, HEDIS and custom review technical resource in support of MSR sales

Job Requirements: 
Experience in managing Credentialing, HEDIS, quality improvement chart abstractions, a
clinical nursing background and experience in leading training programs required. Must be
computer literate, detail oriented and experienced in management. Travel required.
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