Quality Nurse HEDIS – Health Plan Medical Management

Nahsedfw; Irving (TX); On-site; USD 75,000 - 110,000; Full time

Job summary

Christus Health in Irving, TX seeks a Quality Nurse HEDIS - Health Plan Medical Management to join the HEDIS program under the HEDIS Manager. The role emphasizes education for providers and staff and coordinating readiness assessments for CAHPS alongside other HEDIS initiatives.

Typical schedule is 8:00 AM–5:00 PM, Monday through Friday, with responsibilities that include collaborating with internal departments, managing care gaps, data gathering, and training for internal and external customers.

Qualifications

• 4+ years of HEDIS experience required.
• RN or LVN license required.
• Bachelor's or associate degree in nursing required.

Responsibilities

• Collaborate with internal departments to create and implement quality programs.
• Manage care gaps in collaboration with other teams and provider offices.
• Over-read abstracted HEDIS measures and coordinate HEDIS data gathering.
• Track and trend barriers to better outcomes, including access, follow-up and documentation.
• Develop and deliver HEDIS training for internal and external customers.
• Create patient and provider collateral for HEDIS and CAHPS programs.

Skills

HEDIS experience

Clinical experience

CAHPS experience

EMR experience

Education

RN license

Bachelor's or Associate degree in nursing

Tools

EMR systems

Job description

Quality Nurse HEDIS - Health Plan Medical Management

This role works with the HEDIS Manager to develop the HEDIS program according to accreditation changes, provide feedback on program progress and suggest action plans for any deviation from goals. The role develops and coordinates education for providers and staff and conducts routine readiness assessments for CAHPS and other HEDIS initiatives.

Schedule: 8AM to 5PM, Monday through Friday.

What you'll do

• Collaborate with internal departments to create and implement quality programs
• Manage care gaps in collaboration with other teams and provider offices
• Over-read abstracted HEDIS measures and coordinate HEDIS data gathering
• Track and trend barriers to better outcomes, including access, follow-up and documentation
• Develop and deliver HEDIS training for internal and external customers
• Create patient and provider collateral for HEDIS and CAHPS programs

What you bring

• Bachelor's or associate degree (RN) or vocational school graduate (LVN)
• 4+ years of HEDIS experience required
• 4 years of clinical experience preferred
• EMR and CAHPS experience
• RN or LVN license required

About the employer

CHRISTUS Health is a Catholic, faith-based, not-for-profit health system headquartered in Irving, Texas, with hospitals, clinics and health plan operations across Texas, Louisiana, Arkansas, New Mexico and Latin America.

Job summary Quality Nurse HEDIS - Health Plan Medical Management