Overview
HEDIS Improvement Nurse-RN Jobs in Rancho Cucamonga, California, USA at Alura Workforce Solutions
Position: Â HEDIS Improvement Nurse-RN25-00089
Position Title: HEDIS Improvement Nurse-RN
Position Type: Temporary
Schedule: M-F, HYBRID
Assignment Length: 6 Months
Description: Under the direction of the Supervisor, Clinical Quality Improvement, the HEDIS Improvement Nurse provides support to the Supervisor, Clinical Quality Improvement and other departments on HEDIS improvement related issues, serving as a resource for internal and external customers. Is able to interpret clinical data for QI-related studies for medical management. This position maintains a working knowledge of the current medical management system (MedHOK), business processes and workflows.
Maintains summarized information for Quality Systems related to modified and new regulatory requirements for medical management from DHCS, DMHC and CMS.
Qualifications:
Education & Experience:
Registered Nurse, valid non-restricted California licensure.
Three (3) or more years of any individual or combined experience in quality assurance, utilization management, case management, and/or health care informatics is required.
Experience preferably in an HMO or managed care setting.
Key Qualifications:
Working knowledge of NCQA HEDIS technical specifications, medical terminology, and health plan processes preferred.
Seniority Level: Mid-Senior level
Employment Type: Full-time
Job Function: Other
Industries: IT Services and IT Consulting
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Title: HEDIS Improvement Nurse-RN
Company: Alura Workforce Solutions
Location: Rancho Cucamonga, California, USA
Category: Healthcare, Quality Assurance – QA/QC
