Virginia Premier Health Plan, Inc.

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HEDIS Nurse

HEDIS Nurse

Job Locations 
US-VA-Roanoke
Job ID 
2017-4208

Job Description

Overview

THIS IS A TEMPORARY POSITION LASTING FROM JANUARY TO MAY

 

The HEDIS Nurse role will be responsible for the coordination, on-site and telephonic data collection, and data entry and/or uploading of HEDIS data abstracted from medical records.  The sole purpose of this position is for HEDIS data collection and related activities, as assigned.  This position is seasonal. It will commence in Feb/March and end in May/June of each calendar year. Travel is required.

Responsibilities

Planning, organizing and coordinating HEDIS data abstraction activities to include, but not limited to:

  • Scheduling and coordinating on-site medical record reviews
  • Conducting HEDIS Education Site Visits with Providers and Staff
  • Conducting medical record reviews
  • Uploading or data entering outcomes
  • Ensuring that HEDIS processes and outcomes comply with all applicable accreditation standards and regulatory requirements
  • Providing clinical quality management and ad-hoc reporting services, as assigned
  • Working with the quality improvement manager, director and other designated staff to identify and share best practices and opportunities for quality improvement

Qualifications

 

MINIMUM EDUCATION REQUIREMENTS

  • License/Certification:  Current and Valid Registered Nurse or Licensed Practical nurse with a license to practice nursing in the Commonwealth of Virginia

SPECIAL KNOWLEDGE AND/OR SKILLS

  • HEDIS experience
  • Medical record abstraction experience
  • Ability to negotiate with practitioners and providers
  • Ability to communicate effectively verbally and in writing
  • Computer literate
  • Possess knowledge of ICD-10 and CPT4 coding 

WORK BACKGROUND/EXPERIENCE

  • HEDIS experience, preferably in a managed care environment

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position

About Us

Virginia Premier Health Plan, Inc. is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 

 

We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  

 

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

 

Our mission is to inspire healthy living within the communities we serve!

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