Gaining HEDIS Experience for the First Time (Video)

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 2018 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.”

I decided to reach out to a few of my favorite nurses that have established HEDIS experience to ask about their early careers. They all had very similar answers when asked how they secured their first HEDIS opportunity. The most obvious answer was “you have to know someone.” This who-do-I-know approach is certainly one job search strategy that might secure a chance at a position without direct experience, but it is definitely not the only factor. Each of these nurses got the opportunity to be considered, not strictly because they knew someone, but because their background and skills were also a match. They all had a strong background in clinical nursing as well as other specific skills that lined up with the project requirements, such as chart review.

There are a variety of ways you might gain supporting skill sets, and it is important to tailor your resume to showcase these past experience in order to demonstrate that skill set.

As in many professions, you can gain directly related experience in your field before becoming a licensed professional; many current nurses started off as office manager or Medical Assistants. Maybe you worked as a medical assistant or a medical records specialist while obtaining your nursing degree. Perhaps you supported scheduling or document management as a HEDIS associate for a season or two before becoming a licensed nurse. These experiences would have built a skill set that is considered an asset when pursuing of your first HEDIS assignment. These associate positions assist the nursing staff in many ways and can give you valuable experience for future projects.

Of course if you did not gain the related experience early in your career, (maybe you did not even know what HEDIS was back then) it is not too late to develop the supporting skills. If you are passionate about HEDIS assignments, but cannot find work without the direct experience, try volunteering to do chart review and coding activities at your current employer.  If you have the means, you might also consider taking a step back in pay and responsibilities by serving as a HEDIS associate for a season. It may be just enough to get you where you want to be as a HEDIS abstraction nurse next season.

Aside from direct experience doing HEDIS, or HEDIS-related activities, such as chart review and data abstraction, there are a few online resources you should know about.  Of course the National Committee on Quality Assurance (NCQA) is the official place for information on HEDIS and other Quality Improvement initiatives.  A visit to their website pages on HEDIS will allow you to review and familiarize yourself on the measures being analyzed each year (they change regularly).  Just imagine the impact when the first line of your resume (tailored to HEDIS job opportunities of course) states that you are “intimately familiar with the quality measures you will abstract in the current HEDIS season.”  At the very least, you will stand out above other individuals with no prior HEDIS experience, because you took the time to do your homework and can prove it.

Beyond general knowledge, the NCQA offers a wide variety of paid training courses. These range in content and price from less than $100 for an interactive online module about a specific aspect of HEDIS, to an in-person week long seminar that runs more than $10,000 per person. Obviously most of these are designed for employers to purchase for the training of staff.

Now it is time for the bad news.  I receive a lot of resumes from candidates seeking HEDIS opportunities that don’t have any HEDIS experience. I would love to be able to assist these candidates secure an assignment, but I have to keep the best interest of our clients in mind. CareNational’s clients pay us a fee for finding them the best experienced candidates for these openings. Our clients would not need to tap into our specialized expertise to build a talent pool if they are planning to train nurses in HEDIS processes. First-timers and other newcomers to HEDIS are easy enough for them to find on their own, without paying a fee for someone they have to spend time and resources training.

The harsh reality is that the timeline of the HEDIS season is too compressed for many health plans to dedicate substantial time training HEDIS staff from scratch. That is where CareNational comes in, and we partner with health plans and vendors to identify, recruit, and place those nurses with recent direct HEDIS experience. Once you have at least one complete season on your resume, CareNational can be your best recruiting partner, helping you continue working HEDIS projects year after year.

As stated initially, CareNational is an expert in HEDIS staffing and career search consultation in these specialized areas, but we do not perform the functions ourselves. So how did we do? Did you find this information useful? We love feedback!

Comments 19

  1. Where is there a reputable institution to learn HEDIS? Im am LPN of 25 yrs.that lives in FL. with a plethora of knowledge and experience . I don’t know where to look for a site that isn’t a scam site.

  2. Post
    Author

    We did try to answer this in the blog post you commented on, but I apologize if you still had this question after you read the article. As it mentions, the best source is the NCQA training online.

  3. Post
    Author

    NCQA has training online, but prices can be high. There is one company called AdvantMed that offers free online HEDIS training. CareNational is considering doing something similar in the future.

    I should also provide the advice of our in-house HEDIS expert, Kim Williams, CPHQ:
    “A great way to get your foot in the door of HEDIS is a beginning level position. These are usually medical records techs or HEDIS phone team positions. The field medical record techs go to the Provider offices and scan the needed medical records for the HEDIS Abstraction teams. The HEDIS phone teams make the most important FIRST contact with the Provider’s office to either secure the records or space/time in the office for a member of the Abstraction team. I would save my hard earned money and get real life experience.”

  4. Post
    Author

    Hi Rosemary, unfortunately we do not have any CDI positions at the moment. In reality, our clients only ask for our help (and pay our fee) if they cannot fill a position on their own. As such it is rare that we get remote opportunities for any job, including CDI, and we have never had an opportunity that offered strictly weekend hours.

    That said, feel free to email me your resume and I can keep you in mind if we ever have Remote work opportunities taht are a fit for your background. My email is tom@carenational.com, I look forward to receiving your resume and hope we can be a resource for you in the future.

    Tom Hasara
    480-646-3525
    tom@carenational.com

  5. Hi I’m a LPN and still function as a MA for extra money. How can I obtain your training/certification online? Fee? Thank you!

  6. Post
    Author

    Hi Yolonda, We actually do not offer any HEDIS certifications or official training, but he have done several video interviews with HEDIS experts that offer a great overview. You can find several of those HEDIS Stream Highlights here: https://www.youtube.com/user/carenationalservices/playlists

    Finally, I will refer to this section of the blog: “On that note, I would add a word of caution for those looking for HEDIS education or certification. There are a number of companies that will charge individuals money, provide some level of training and testing, and then claim these individuals are now “certified” in HEDIS. Sadly, most of these organizations are other staffing firms who then present these “certified” candidates to their clients for employment. Essentially, they are trying to collect money from both sides of the equation. That is not how we operate. We are a 100% free service to the candidate, and we will never, ever, charge you money to help you find work. Bottom line, aside from the official NCQA website, CareNational does NOT endorse any other for-pay HEDIS training or certification.”

  7. Post
    Author

    Hi Karen, No, you do not have to be a Nurse to work a HEDIS project.
    HEDIS is a large-scale program, with a lot of different components and players to it. We talk a lot about the “production” side of HEDIS work, and by that we mean the chart review and data abstraction, followed by the quality-control of that work called over-reading. For these roles our clients often prefer nurses (RNs or LPNs/LVNs) because they are familiar with medical records and have the clinical background to understand what they are looking at. For the same reason, are clients will sometimes look for certified coders (CCS/CPC or RHIA/RHIT, etc).
    However there is a lot of administrative work to be done before the charts are ready for review by nurses or coders. In addition to coordinating the schedule with each provider office and facility, the correct sample of records must be gathered together, and then records will need to be set aside for either an onsite review or, more commonly, the records will be faxed or scanned so the review can happen remotely at corporate offices (or home offices for some). These administrative HEDIS support roles are open to a wider variety of backgrounds, such as Medical Assistants, CNAs, or front-office receptionists, as long as they have some experience with healthcare, HIPAA, and medical record handling.

    I hope that helps!

  8. Post
    Author
  9. Hi
    After reading all the way through to end you are now offering training? RN with ICU/GI/IR/CATH LAB/PACU/ Quality risk-peer review-abstract-core measures-RCA and outpatient ER coding. I want to do Hedis.
    Thanks

  10. Hi Notasha, thanks for reaching out to us. Our class is ongoing year round, you’re able to jump in and complete the course at anytime. As we near closer to the beginning of the next HEDIS Season, we will be updating our materials with the new HEDIS guidelines. We’ll be posting updates on our sites and social media when we update our courses. If you have any other questions, please feel free to email help@hediscertify.com

  11. Hi Wendy, Thanks for reaching out to us. If you’re interested in our training, you can go to hediscertify.com and register for one of our classes. We are currently having a special until the end of December 27th where you can get both of our courses, Abstraction Training and Chart Chaser training for $250. Our Abstraction Training prices is locked at $199 until 2019 as well.

  12. Hi
    Good Evening I’m glad to read your message about Hedis
    how can I join in your training is do you have free Im a CNA and
    also I’m CCS license , active doing remote in HCC. Can you email
    tome your exact website if you have training in online.
    Thaks ,
    Benilda

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