Quality RN - North Charleston SC

CenterWell • Charleston, SC

8d • Onsite

About The Position

Become a part of our caring community and help us put health first The Quality RN Professional responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Quality RN Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Quality RN Professional collaborates with market leadership , and quality improvement team to develop and implement programs designed to increase patient outcomes . W ork is performed within the associate’s assigned center locations and in collaboration with existing Quality Improvement Coordinators and Professionals and in close partnership with market and center teams. The Quality RN Professional represents the scope of provider relationships across the following areas: Quality/clinical management and population health HEDIS and Stars performance Operational improvements Financial performance and incentive programs Data sharing and connectivity Documentation and coding Additional areas related to provider performance, member experience, market growth, provider experience and operational excellence Use your skills to make an impact

Requirements

• Licensed Registered Nurse (RN) without restriction in applicable state
• 5+ years of clinical nursing experience
• Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement
• Strong knowledge of HEDIS/Stars/CMS
• Excellent presentation and communication skills, both oral and written
• Strong relationship building skills as this is a provider-facing role
• Strong attention to detail with a focus on process and quality
• Comprehensive knowledge of Microsoft Office applications

Nice To Haves

• Bachelor’s D egree in Nursing
• 3+ years of managed care experience
• 3+ years of case management experience
• Bilingual; English and Spanish pre ferred, not

Benefits

• Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level