Remote HEDIS Quality Liaison - RN

Hispanic Alliance for Career Enhancement; California (MO); Hybrid; USD 54,000 - 156,000; Full time

Job summary

CVS Health is seeking a Quality Practice Liaison to work from home supporting the Arizona Mercy Care Plan. You will present HEDIS gaps in care data to provider groups and educate on NCQA specifications to improve member outcomes.

You will obtain, review, abstract, and data enter medical records for HEDIS supplemental data, collaborating with health plan project managers and other departments while working remotely.

Qualifications

• Active and unrestricted Arizona or compact state RN license.
• 3+ years of clinical experience as an RN.
• 2+ years of experience with HEDIS quality measures.
• 1+ years of experience with delivering presentations.
• Proficiency with Microsoft Outlook, Teams, Word, Excel, PowerPoint, Adobe Acrobat, Windows 10, and QuickBase.
• Willingness to travel in the state of Arizona up to 10% of time, if commutable.

Responsibilities

• Generates and distributes gap in care reporting from Tableau Dashboard.
• Actions outreach, scheduling meetings, developing presentations, and conducting meetings with provider groups to share HEDIS information.
• Reviews documentation and abstracts compliant medical record data for entry into supplemental data tool.
• Contacts the providers of record, vendors, or internal Aetna departments to obtain additional information as needed.
• Commands a comprehensive knowledge of NCQA HEDIS and STARS Measures for both Medicare and Medicaid.
• Works with a variety of electronic tools to accomplish team goals.
• Performs other duties as needed.

Skills

RN license

Clinical RN experience

HEDIS quality measures

Presentation experience

Professional communication

Education

Associate Degree in Nursing

Tools

Microsoft Outlook

Microsoft Teams

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Adobe Acrobat

Windows 10

QuickBase

Job description

CVS Health is seeking a Quality Practice Liaison to work from home supporting the Arizona Mercy Care Plan. You will present HEDIS gaps in care data to provider groups and educate on NCQA specifications to improve member outcomes.

You will obtain, review, abstract, and data enter medical records for HEDIS supplemental data, collaborating with health plan project managers and other departments while working remotely.