HEDIS Specialist

Healthcare Support Staffing; Long Beach (CA); On-site; USD 70,000 - 95,000; Full time

Job summary

A leading healthcare staffing firm is seeking an experienced Registered Nurse to join their team in Long Beach, California. The position involves reviewing and investigating quality of care issues, conducting member outreach, and preparing case summaries for the medical director. Candidates must possess an active CA RN license and at least 3 years of clinical experience. Exceptional communication and professional writing skills are essential for success in this role, providing a chance to advance your nursing career within a prestigious company.

Qualifications

• 3+ years clinical experience required.
• Active California RN license needed.
• Experience with NCQA, HEDIS, or QA/QI preferred.

Responsibilities

• Review and investigate quality of care issues.
• Conduct member outreach via phone calls.
• Prepare case summaries and present findings to medical director.

Skills

MS applications knowledge (spreadsheets)

Clinical experience

Professional writing ability

Verbal communication skills

Comfortable with Member Outreach

Education

Active CA RN license

Job description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Are you an experienced Registered Nurse looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes” to any of these questions – this is the position for you!

Qualifications

• MS applications knowledge (spreadsheets)
• Active CA RN license
• 3+ years clinical experience
• Experience with NCQA, HEDIS or QA/QI
• Medical Record Retrieval and Review
• Comfortable with Member Outreach
• Professional writing and verbal abilities as summaries and presentations of findings to medical director are required

Additional Information

• Nurses will be reviewing and investigating quality of care issues and grievances, which is why clinical experience is required.
• Also, professional writing and verbal abilities are required because case summaries and presentations of findings to medical director are required
• Medical records retrieval/review, uploading data into spreadsheets, member outreach, (phone calls to members)