Hedis Improvement Nurse, Rn - Rancho Cucamonga, United States - Inland Empire Health Plan

Inland Empire Health Plan
Inland Empire Health Plan
Verified Company
Rancho Cucamonga, United States

3 weeks ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

What you can expect
Find joy in serving others with IEHP We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an
authentic experience


Under the direction of the Supervisor, Clinical Quality Improvement, the HEDIS Improvement Nurse provides support to the Supervisor, Clinical Quality Improvement and IEHP 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.


Commitment to Quality:

The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.


Perks


IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.


  • Competitive salary.
  • Hybrid schedule.
  • State of the art fitness center onsite.
  • Medical Insurance with Dental and Vision.
  • Generous paid time off
- vacation, holidays, sick


Assignment Duration:
Up to 6-month


Education & Experience

  • Associates degree required
  • 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
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