Remote Pediatric HEDIS Outreach Nurse

Humana; Oklahoma City (OK); Hybrid; USD 48,000 - 65,000; Full time

Job summary

Humana in Oklahoma City is seeking a Telephonic Quality Outreach Professional to support the EPSDT program by evaluating member needs and coordinating services to promote pediatric wellness. This role emphasizes telephonic outreach, collaboration with EPSDT teams, and adherence to Bright Futures guidelines to close HEDIS gaps.

The position requires an LPN in Oklahoma, at least 2 years in health care or insurance, and a remote/hybrid setup with 2 days in the office.

Qualifications

• Unrestricted Licensed Practical Nurse (LPN) in the state of Oklahoma.
• Remote/hybrid work—2 days a week in office.
• Prior experience in a health insurance or health care setting.
• At least 2 years of technical experience.
• Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint.
• Must be passionate about contributing to an organization focused on improving consumer experiences.

Responsibilities

• Telephonic outreach to close HEDIS gaps for Medicaid pediatric population.
• Assist members in addressing barriers to care, including scheduling challenges and transportation needs.
• Collaborate with EPSDT Senior Quality Improvement Professional and Coordinator on strategic outreach to maximize HEDIS outcomes.
• Collaborate with other departments.
• Provide vaccine awareness and education following Bright Futures and EPSDT preventive health guidelines.
• Empower member independence through education and outreach that promote ongoing self-sufficiency in managing preventive and primary care needs.
• Other responsibilities as assigned.

Education

Licensed Practical Nurse (LPN) in Oklahoma

Tools

Microsoft Office Word

Excel

PowerPoint

Job description

Humana in Oklahoma City is seeking a Telephonic Quality Outreach Professional to support the EPSDT program by evaluating member needs and coordinating services to promote pediatric wellness. This role emphasizes telephonic outreach, collaboration with EPSDT teams, and adherence to Bright Futures guidelines to close HEDIS gaps.

The position requires an LPN in Oklahoma, at least 2 years in health care or insurance, and a remote/hybrid setup with 2 days in the office.