Remote Quality Outreach RN – HEDIS & Care Coordination

Tenavi Staffing

Pennsylvania

Remote

USD 70,000 - 100,000

Full time

2 hours ago

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Job summary

Tenavi Staffing is seeking an experienced Quality Outreach RN to support quality outreach initiatives and member engagement in a fully remote contract role. The courier will leverage clinical knowledge and quality program expertise to conduct member outreach, support care gap closure, and contribute to improved quality performance and member outcomes.

The ideal candidate has HEDIS experience, managed care background, and strong communication and documentation skills.

Qualifications

Requires HEDIS experience with gap closure and quality outreach.
Experience in Medicare/Medicaid or government programs populations preferred.
Minimum 3–5 years in managed care, population health, or quality programs.
Strong written and verbal communication and documentation skills.
Experience in remote or telehealth environments is preferred.

Responsibilities

Conduct outbound member outreach to support HEDIS gap closure and preventive care compliance.
Coordinate care across providers and settings to support continuity of care.
Monitor member progress and identify barriers to treatment adherence.
Review medical records, claims data, and HEDIS measures to identify intervention opportunities.
Support quality initiatives focused on improving HEDIS, Stars, and member experience metrics.
Document outreach activities, barriers, and outcomes accurately and timely.
Collaborate with clinical and quality teams to support reporting and compliance initiatives.
Maintain HIPAA compliance and adhere to regulatory requirements.