Healthcare Management Solutions, LLC
Healthcare Management Solutions, LLC
51 – 200 Employees
ConsultingGovernmentHealthcare
Healthcare Management Solutions, LLC is a U.S.-focused healthcare consulting and services firm that works with federal and state agencies, including the Centers for Medicare & Medicaid Services, as well as nonprofit healthcare organizations. Since 2002, the company has supported initiatives focused on healthcare quality, safety, access, and regulatory compliance. Its work includes health facility inspections, state operations support, health insurance marketplace compliance, payment model projects, medical record review, and healthcare information technology solutions. The company also emphasizes employee ownership and collaboration with prime and subcontractor partners, creating opportunities for professionals interested in public-sector healthcare, healthcare operations, consulting, and technology.

Congenital Heart Surgery Database Reviewer - Remote

Healthcare Management Solutions seeks a remote clinical reviewer to audit congenital heart surgery registry submissions against medical records. The role focuses on validating STS data, documenting discrepancies, and supporting audit quality standards.

Description

  • Audit clinical information submitted to the STS Congenital Heart Surgery Database against the corresponding medical records
  • Verify case eligibility, procedure codes, outcomes, and registry fields for accuracy and completeness
  • Record agreements, discrepancies, and possible data-quality issues in HMS audit systems
  • Examine operative reports, progress notes, diagnostic results, discharge summaries, and related documentation
  • Complete introductory and continuing reviewer training
  • Achieve defined productivity, quality, and inter-rater reliability targets
  • Route questions about data definitions, documentation meaning, or audit conclusions through the appropriate channels
  • Support adjudication and documentation reviews after sites respond to preliminary audit results
  • Prepare concise, professional explanations of audit decisions and the evidence supporting them
  • Protect confidential information and follow HMS security, privacy, and data-protection policies
  • Join team meetings and project calls as required
  • Handle additional assigned responsibilities

Requirements

  • Hold an RN, physician, physician assistant, nurse practitioner, perfusionist, or another clinical healthcare license
  • Have at least two years of recent experience in clinical practice, registry abstraction, quality improvement, or auditing
  • Demonstrated experience evaluating complex medical records
  • Strong knowledge of clinical documentation standards and medical terminology
  • Proficiency with Microsoft Office and electronic medical record systems
  • Ability to work independently in a remote setting
  • Strong analytical, organizational, and communication abilities
  • Ability to meet defined deadlines and quality expectations
  • Experience with the STS Congenital Heart Surgery Database is preferred
  • Prior registry auditing or data-validation experience is preferred
  • Experience in pediatric cardiology, congenital heart surgery, pediatric intensive care, cardiovascular surgery, or a related field is preferred
  • Familiarity with STS data definitions, abstraction guidance, and performance measures is preferred
  • Experience using Epic, Cerner, Meditech, or another major EMR platform is preferred
  • Experience interpreting operative reports and congenital cardiac procedure documentation is preferred
  • Knowledge of congenital cardiac anatomy, procedures, and terminology
  • Ability to interpret clinical documentation accurately and apply registry definitions
  • Ability to handle multiple assignments concurrently
  • Ability to quickly learn and use new audit tools, workflows, and guidelines

Benefits

  • Remote work arrangement
  • Part-time employment
  • Reviewer training opportunities
  • Equal opportunity employer
  • Affirmative action workplace
  • E-Verify-compliant workplace
  • Drug-free workplace

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