Temporary HEDIS Improvement Nurse, RN (Hybrid Work Schedule)
About The Position
This position is a temporary role facilitated through one of our contracted agencies and is not a direct employment opportunity with IEHP. The contracted agency offers an assignment length of up to six months, during which the candidate will provide support for IEHP. What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Under the direction of the Supervisor, Clinical Quality Improvement, the HEDIS Improvement Nurse provides support to the Supervisor, Clinical Quality Improvement and IEHP departments on HEDIS improvement related issues, serving as a resource for internal and external customers. Is able to interpret clinical data for QI-related studies for medical management. This position maintains a working knowledge of the current medical management system (MedHOK), business processes and workflows. Maintains summarized information for Quality Systems related to modified and new regulatory requirements for medical management from DHCS, DMHC and CMS. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
Requirements
- Associates degree required
- Three (3) or more years of any individual or combined experience in quality assurance, utilization management, case management, and/or health care informatics is required
- Experience preferably in an HMO or managed care setting
Nice To Haves
- Working knowledge of NCQA HEDIS technical specifications, medical terminology, and health plan processes preferred
Responsibilities
- Provides support to the Supervisor, Clinical Quality Improvement and IEHP departments on HEDIS improvement related issues
- Serves as a resource for internal and external customers
- Interprets clinical data for QI-related studies for medical management
- Maintains a working knowledge of the current medical management system (MedHOK), business processes and workflows
- Maintains summarized information for Quality Systems related to modified and new regulatory requirements for medical management from DHCS, DMHC and CMS
- Incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation
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What This Job Offers
Industry
Religious, Grantmaking, Civic, Professional, and Similar Organizations
Education Level
Associate degree
Number of Employees
1,001-5,000 employees
