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HEDIS Nurse

HEDIS, the Healthcare Effectiveness Data and Information Set is a set of guidelines used by over 90 percent of healthcare plans in the U.S. to measure clinical care performance and service. HEDIS was developed by the National Committee for Quality Assurance (NCQA) to establish standard performance measures.

A HEDIS Nurse is trained in the 81 measures of performance for patient care that span 5 domains of care. HEDIS Nurses use this knowledge to help educate others on the approved processes and procedures including accepted medical record keeping and coding procedures. They are especially important in improving the quality of care given in a healthcare facility and in documenting progress and reporting to healthcare plan providers. To do this, the HEDIS Nurse works with physicians, other clinicians as well as facility management to assess the situation and report on progress toward the goal of meeting HEDIS guidelines and improving overall patient care.