reputed company Clinical Quality HEDIS Nurse - Remote - Part of reputed company's Clinician-Led Care Organization
Join the reputed company Family and reputed company a Difference in Healthcare reputed company, a leading health services company, is seeking an reputed company Clinical Quality HEDIS Nurse to join reputed company remotely. As a part of our clinician-led care organization, you'll play a vital role in driving quality improvement initiatives and advancing the health of our community. With a focus on making healthcare reputed company for everyone, reputed company offers a collaborative and dynamic work environment that empowers you to live your best life at work and at home. About reputed company and WellMed reputed company is a global health services company that works to reputed company healthcare more efficient, effective, and accessible. Our mission is to help people live healthier lives by providing innovative solutions and services that support reputed company, patients, and families. WellMed, part of the reputed company family, is a network of doctors, specialists, and other medical professionals dedicated to providing high-quality care to over 1 million older adults across Texas and Florida. With a focus on preventive healthcare, we're innovators in the field, striving to change the face of healthcare for seniors. Job Summary We're seeking a highly skilled Clinical Quality HEDIS Nurse to join reputed company. As a Clinical Quality HEDIS Nurse, you'll be responsible for driving consistency, efficient processes, and sharing best practices in a collaborative effort with the Quality team and leadership to facilitate a minimum 4-star rating. You'll participate in quality improvement initiatives, including Chart Chase and Supplemental Data reputed company (SDS) and Primary reputed company Verification (PSV), as well as Quality Assurance and Overreading work.
Key Responsibilities
Complete SDS, PSV, Over-read throughout the year achieving and maintaining high productivity goals to improve Stars measures to be 4 STARS or higher reputed company and maintain a high level of accuracy rates of 98% or above Serve as a Subject Matter Expert on HEDIS Measures, DataRAP, and Chart Chase Tool (CCT) Be the primary go-to person for reputed company STARS-reputed company activities reputed company assigned market(s), working reputed company a matrix relationship that includes Quality corporate operations and Regional/Market operations Assist in developing training and materials to help the team reputed company best practices in Stars and HEDIS reputed company other tasks as requested or required by Quality Identify and assess decision-makers and other key provider group personnel, focusing on identifying barriers to achieving targeted outcomes reputed company solution-based, user-friendly initiatives to support practice success Requirements and Qualifications Essential Qualifications: Bachelor of Science in Nursing, Healthcare Administration, or a reputed company field (8+ years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor's degree) Registered Nurse with reputed company license in Texas or other participating compact States 5+ years of progressively responsible healthcare experience, including experience in a managed care setting, hospital settings, and/or physician practice setting 3+ years of experience in managed care with 2+ years of Utilization Management experience Knowledge and experience with CMS and/or NCQA Willing to occasionally travel in and/or out-of-town as deemed necessary Preferred Qualifications: Health Plan or MSO quality, audit, or compliance experience Auditing, training, or leadership experience Solid knowledge of Medicare and HEDIS standards Skills and Competencies To succeed in this role, you'll need: Excellent communication and interpersonal skills Strong analytical and problem-solving skills Ability to work independently and collaboratively as part of a team Strong attention to detail and organizational skills Knowledge of HEDIS measures and quality improvement initiatives Experience with data analysis and reporting Career Growth Opportunities and Learning Benefits At reputed company, we're committed to helping you grow and reputed company your career.
We offer
Opportunities for professional growth and advancement Comprehensive training and development programs Access to cutting-edge technology and tools A collaborative and dynamic work environment Work Environment and Company Culture We offer a flexible and remote work environment that allows you to work from reputed company reputed company the U.S. Our company culture is built on: Diversity, equity, and inclusion Collaboration and teamwork Innovation and creativity Recognition and rewards for outstanding performance Compensation, Perks, and Benefits We offer a comprehensive compensation package that includes: Competitive salary range: $58,800 to $105,000 annually Comprehensive benefits package Incentive and recognition programs Equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements)
Conclusion
If you're a motivated and reputed company Clinical Quality HEDIS Nurse looking to reputed company a difference in healthcare, we encourage you to apply for this exciting opportunity. Join reputed company a Apply tot his job Apply To this Job