Remote HEDIS Quality Liaison (RN)

Hispanic Alliance for Career Enhancement; Rhode Island; Hybrid; USD 54,000 - 156,000; Full time

Job summary

CVS Health is seeking a Quality Practice Liaison for a remote, work-from-home role supporting the Arizona Mercy Care Plan. You will be responsible for presenting HEDIS gaps in care data to provider groups, educating on HEDIS measures, and obtaining, abstracting, and entering medical records used for supplemental data processes.

You will work with NCQA HEDIS specifications, collaborate with health plan project managers, and access diverse EMR systems remotely to meet volume and accuracy targets.

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.
• Demonstrated proficiency technology, keyboarding, and various systems, including 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 experience

HEDIS knowledge

Presentations

Tech proficiency

Remote work tools

Travel up to 10%

Education

Associate Degree in Nursing

Tools

Microsoft Outlook

Microsoft Teams

Word

Excel

PowerPoint

Adobe Acrobat

Windows 10

QuickBase

Job description

CVS Health is seeking a Quality Practice Liaison for a remote, work-from-home role supporting the Arizona Mercy Care Plan. You will be responsible for presenting HEDIS gaps in care data to provider groups, educating on HEDIS measures, and obtaining, abstracting, and entering medical records used for supplemental data processes.

You will work with NCQA HEDIS specifications, collaborate with health plan project managers, and access diverse EMR systems remotely to meet volume and accuracy targets.