HEDIS Improvement Nurse

Job not on LinkedIn

🔥 1 minute ago

🏄 California – Remote

🏄 California – Remote

💵 $91.2k - $120.9k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 1%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

IEHP

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1995

🛡️ Insurance

💼 Consulting

📦 Logistics

💰 Grant on 2021-02

Insurance • Consulting • Logistics

IEHP is a health plan dedicated to serving low-income individuals and families in Riverside and San Bernardino counties. They offer a variety of programs including Medi-Cal, DualChoice, and Covered California, providing healthcare coverage for residents who may not otherwise have access to necessary medical services. With a focus on holistic health and community wellness, IEHP partners with local doctors and facilities to ensure comprehensive care for their members, supporting them with resources in mental health, fitness classes, and wellness education.

📋 Description

• Provide support to the Supervisor, Clinical Quality Improvement, and IEHP departments on HEDIS improvement-related issues • Serve as a resource for internal and external customers • Interpret clinical data for QI-related studies for medical management • Maintain working knowledge of current medical management systems, business processes, and workflows • Maintain summarized information for Quality Systems related to modified and new regulatory requirements from DHCS, DMHC, and CMS • Support IEHP Quality Program goals, including HEDIS, CAHPS, and NCQA Accreditation

🎯 Requirements

• Three (3) or more years of any individual or combined experience in quality assurance, utilization management, case management, and/or health care informatics • Experience in an HMO or managed care setting preferred • Associate's degree in Nursing from an accredited institution required • Bachelor's degree in Nursing from an accredited institution preferred • Possession of an active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the California BRN required • Advanced knowledge of NCQA HEDIS technical specifications, medical terminology, and health plan processes preferred • Advanced knowledge of the current medical management systems and how information is stored and retrieved • In-depth understanding of current HEDIS technical specifications, with the ability to interpret changes and clarifications accurately • Basic knowledge of Microsoft Access • Data analysis and computer applications, including word processing, databases, and spreadsheets • Proficient in Microsoft Office Suite • Excellent interpersonal/communication skills • Ability to handle multiple projects and data input • Strong problem-solving capability • Strong attention to detail

🏖️ Benefits

• Competitive salary • State of the art fitness center on-site • Medical Insurance with Dental and Vision • Life, short-term, and long-term disability options • Career advancement opportunities and professional development • Wellness programs that promote a healthy work-life balance • Flexible Spending Account – Health Care/Childcare • CalPERS retirement • 457(b) option with a contribution match • Paid life insurance for employees • Pet care insurance

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume