Temporary HEDIS Improvement Nurse, RN (Hybrid Work Schedule) at IEHP Rancho Cucamonga, CA

Comunidade Metodista; Rancho Cucamonga (CA); Hybrid; USD 51.000 - 69.000; Vollzeit

Zusammenfassung

IEHP seeks a Temporary HEDIS Improvement Nurse, RN in Rancho Cucamonga, CA. This agency-facilitated assignment lasts up to six months and supports IEHP’s clinical quality improvement initiatives.

Under supervision, the nurse interprets data for QI studies and maintains knowledge of MedHOK and related regulatory requirements from DHCS, DMHC, and CMS, contributing to IEHP’s quality goals.

Qualifikationen

• Associates degree required.
• Three+ years in quality assurance, utilization management, case management, or health informatics.
• HMO or managed care experience preferred.
• Working knowledge of NCQA HEDIS technical specs and health plan processes preferred.

Aufgaben

• Assist Supervisor, Clinical Quality Improvement with HEDIS issues.
• Interpret clinical data for quality improvement studies and support medical management.

Kenntnisse

HEDIS knowledge

Ausbildung

Associates degree

Jobbeschreibung

Temporary HEDIS Improvement Nurse, RN (Hybrid Work Schedule) job at IEHP. Rancho Cucamonga, CA.

This position is a temporary role facilitated through one of our contracted agencies and is not a direct employment opportunity with IEHP. The contracted agency offers an assignment length of up to six months, during which the candidate will provide support for IEHP.

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the Supervisor, Clinical Quality Improvement, the HEDIS Improvement Nurse provides support to the Supervisor, Clinical Quality Improvement and IEHP departments on HEDIS improvement related issues, serving as a resource for internal and external customers. Is able to interpret clinical data for QI-related studies for medical management. This position maintains a working knowledge of the current medical management system (MedHOK), business processes and workflows. Maintains summarized information for Quality Systems related to modified and new regulatory requirements for medical management from DHCS, DMHC and CMS. Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Education & Experience

• Associates degree required
• Three (3) or more years of any individual or combined experience in quality assurance, utilization management, case management, and/or health care informatics is required
• Experience preferably in an HMO or managed care setting

Key Qualifications

• Working knowledge of NCQA HEDIS technical specifications, medical terminology, and health plan processes preferred

Pay Range

• $43.87 USD Hourly - $43.87 USD Hourly