HEDIS Nurse

🔥 1 minute ago

🏄 California – Remote

🏄 California – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.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.

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SCAN

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1977

🏥 Healthcare

⚕️ Healthcare Insurance

👥 B2C

Healthcare • Healthcare Insurance • B2C

SCAN is a mission-driven healthcare organization focused on reinventing aging by delivering evidence-based, patient-centered care and coverage for older adults. It operates an integrated portfolio including health insurance plans with innovative benefits, in-home and virtual primary care, support programs for caregivers and homebound older adults, and specialized services for vulnerable populations. SCAN also invests in and partners with companies that advance care models and resources to help older adults remain healthy and independent at home.

📋 Description

• Review medical records for Quality Initiatives/HEDIS® reporting • Conduct outreach to members and/or providers to collect necessary data and complete medical records and reporting information • Discuss medication adherence and procedures needed to address gaps in care, including bone density testing and colorectal cancer screenings • Abstract clinical data from medical records per NCQA guidelines and internal procedures • Communicate with members and providers regarding Quality Initiative projects and enter findings into the designated database • Document all member interactions as specified by the project manager • Identify pursuit opportunities and work with pursuit assistants to retrieve medical record information • Evaluate clinical information to obtain needed data from members and/or providers within project timelines • Pursue missing data throughout the review process • Follow project manager directives to meet project objectives and timeframes • Coordinate with HEDIS® staff to update and track medical records for reporting • Maintain professional and technical knowledge through educational workshops, professional publications, personal networks, and professional societies • Support projects and interventions across departments as needed • Review medical records and abstract pertinent information as directed by the project manager • Support SCAN’s vision and goals • Perform other duties as assigned

🎯 Requirements

• Associate's Degree or equivalent experience or Technical Degree • Registered Nurse (RN) or Licensed Vocational Nurse (LVN) required • 2-3 years of related experience • 0-1 years of leadership experience • Knowledge of the field's policies, procedures, and practices • Leads and directs the work of other employees • Background check required • Curiosity about AI and its power to transform how we operate and serve our members

🏖️ Benefits

• This is a temporary opportunity for a limited period of time • Remote work • Medical Benefits • Paid Sick Time • Excellent 401(k) Retirement Saving Plan • Robust employee recognition program • An opportunity to become part of a team that makes a difference to our members and our community every day