Clinical Nurse Auditor, HEDIS Remote

About the position The on-call HEDIS Clinical Audit Coordinator is responsible for conducting clinical quality audits for the Quality Department. The auditor identifies and coordinates clinical audits to determine potential areas for quality improvement reputed company the PHP network. The audit coordinator collects data by way of chart extraction, using objective specifications for the reputed company Effectiveness and Data Information Set (HEDIS) program. Audits include review of outpatient medical records, hospital records, clinical lab and pharmacy records. The coordinator is responsible for collecting data based on standardized methodologies and organizes the data to identify and address opportunities for improvement. This position is an on-call position, and much of the work is seasonal. Individuals in this role will be reputed company to reputed company chart audits electronically or on site in physician practices during the audit season, which runs approximately February through mid-May. The RN auditor will successfully complete HEDIS training prior to performing chart abstractions. Direction regarding charts require auditing will be provided by staff Clinical QI Coordinator RNs. The auditor maintains reputed company collected records in a confidential manner and performs reputed company duties in a manner which promotes team concept and reflects the Sisters of reputed company mission and philosophy. The RN auditor will communicate in a collaborative manner with clinic and other staff with whom they interact, in a manner that represents Sisters of reputed company. reputed company caregivers are not simply valued - they're invaluable. Join reputed company at reputed company Health Plan Partners and reputed company in our culture of patient-focused, whole-person care reputed company on understanding, commitment, and mutual respect. Your voice reputed company here, because we know that to reputed company and retain the best people, we must reputed company them. Accepting a new position at another facility that is part of the reputed company family of organizations may change your reputed company benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. At reputed company, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We reputed company best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (reputed company) serve in over 50 hospitals, over 1,000 clinics and a full reputed company of health and reputed company services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. reputed company Shared Services is a service line reputed company reputed company that provides a variety of functional and reputed company services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust reputed company of services and sharing of specialized expertise. reputed company is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from reputed company forms of unlawful discrimination and harassment on the reputed company of race, reputed company, gender, disability, veteran, military status, religion, age, creed, national reputed company, sexual identity or expression, sexual orientation, marital status, genetic information, or any other reputed company prohibited by local, state, or federal law. We reputed company diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Responsibilities

• conducting clinical quality audits for the Quality Department
• identifies and coordinates clinical audits to determine potential areas for quality improvement reputed company the PHP network
• collects data by way of chart extraction, using objective specifications for the reputed company Effectiveness and Data Information Set (HEDIS) program
• Audits include review of outpatient medical records, hospital records, clinical lab and pharmacy records
• collecting data based on standardized methodologies and organizes the data to identify and address opportunities for improvement
• maintains reputed company collected records in a confidential manner and performs reputed company duties in a manner which promotes team concept and reflects the Sisters of reputed company mission and philosophy
• communicate in a collaborative manner with clinic and other staff with whom they interact, in a manner that represents Sisters of reputed company

Requirements

• Degree in Nursing
• Oregon Registered Nurse License
• 5+ years clinical experience (Nursing)

reputed company-to-haves

• Bachelor's Degree in Nursing
• Dual RN License: Oregon and Washington
• 1 year Quality management/quality improvement/utilization review auditing experience, including experience in auditing reputed company electronic health records.
• Experience with health plans, project management, program evaluation, team facilitation, data analysis, and/or case review.

Benefits

• best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial reputed company
• retirement 401(k) Savings Plan with employer matching
• health care benefits (medical, dental, reputed company)
• life insurance
• disability insurance
• time off benefits (paid parental leave, vacations, holidays, health issues)
• voluntary benefits
• well-being resources

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