Quality Improvement Nurse
The ideal candidate for this position will be an LPN or RN in the state of Utah with experience working with HEDIS and the Stars Program.
The Quality Improvment Nurse is an autonomous role within our quality department. This individual will travel to different clinic sites, work in an office setting, and provide training. The trainings will include physicians and office staff. This role will directly impact the care our Medicare patients receive, improve process flow for all patients, and improve our STARS score.
The Quality Improvement Nurse will facilitate and work collaboratively with provider groups to guide, recommend, and develop practice specific strategies designed to improve patient quality of care and patient satisfaction for our Medicare Advantage population.
The Quality Improvement Nurse will strategically collaborate with Health Choice providers and clinics to maximize quality scores. He/she acts as a liaison to facilities, providers, and/or members. Educates on quality programs and best practices. Reviews medical records to close care gaps and identify needed improvements that impact HEDIS measures or coding. Identifies membership/provider/clinic needs and removes any barriers in achieving optimal Effectively implement clinic strategies to enhance patient experience / satisfaction.
Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment - while still being valued for your individual strengths - Health Choice is the place for you.
Equal Opportunity Employer Minorities/Women/Veterans/Disabled
High School Diploma or GED
Associate's or Bachelor's degree from an accredited Nursing School preferred; Licensed Practical Nurse considered
At least two (2) years of experience in a health care setting
Managed Care experience
Medicare Stars program experience
Previous clinical or health plan operations experience