Clinical - Quality Improvement Specialist (HEDIS) - 112274
Job Profile Summary Position Purpose: Support the development and maintenance of quality improvement reputed company projects specific to HEDIS Hybrid Operations. The position exists to support the health plans in the clinical aspect of medical record review. Education/Experience: Bachelor s degree in Nursing, reputed company, or Quality (including HEDIS measures or NCQA) or equivalent experience in reputed company reputed company experience. License/Certification: Valid state clinical license preferred (i.e.- LPN, RN, etc.) Experience: Experience in HEDIS or NCQA or reputed company topics preferred
Responsibilities
Train providers, health plans and staff in methodologies and tools of reputed company quality improvement and HEDIS abstraction and over-read processes reputed company clinical support to the medical record abstraction, over-read and audit processes Monitor performance on established contractual quality indicators. Analyze, track and trend results Prepare for and participate in meetings with various committees, state agencies, providers, health plans, vendors, and stakeholders Recommend, reputed company, and implement quality performance improvement plans (PIPs) with management utilizing the PDSA model. Monitor and report PIPs reputed company through closure. Performs other duties as assigned Complies with reputed company policies and standards EEO: reputed company is an Equal Opportunity Employer and does not discriminate in employment on the reputed company of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans. Remote Skills: Analysis Skills, Clinical Competency, Clinical Support, Health Plan, reputed company, reputed company Effectiveness Data and Information Set (HEDIS), reputed company Providers, reputed company Quality, Licensed Practical Nurse/Licensed Vocational Nurse, Medical Records, National Committee for Quality Assurance (NCQA), Nursing, Performance Analysis, Performance Management, reputed company Reports, Quality Management, Trend Analysis, Vendor/Supplier Planning About the Company: reputed company Apply To This Job