HEDIS Nurse

Job not on LinkedIn

🕒 September 28

🏄 California – Remote

🏄 California – Remote

💵 $40 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 12%

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.

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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 care-gap procedures, including bone density testing and colorectal cancer screenings. • Abstract clinical data from medical records according to 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 collaborate 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 records-review process. • Follow project manager directives and coordinate with HEDIS® staff to update and track medical records for reporting. • Support projects and interventions across departments, including HCS and Pharmacy, as needed. • Attend educational workshops, review professional publications, establish professional networks, and participate in professional societies. • Actively support SCAN’s vision and goals and 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. • Background check required. • Curious about AI and its power to transform operations and member service.

🏖️ Benefits

• 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!

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