Description: Under the direction of the Administrative Director of Health Services or designee, the HEDIS RN will lead all clinical activities related to monitoring, assessing and improving the performance in ambulatory, outpatient and clinic health care delivery or health care related services to KFHC membership through the HEDIS process. The HEDIS RN will provide leadership for all elements of the HEDIS process and communicate with contracted providers regarding opportunities for improvement. He or she will participate in records reviews, chart abstractions and over-reading records as part of the HEDIS process which includes planning, organizing, data collection and validation, tabulation and report writing.
*2,000 SIGN ON BONUS*
Requirements: Possession of a valid California Registered Nursing License. Five (5) years of RN experience in an acute health care setting in Emergency, Critical and/or general Medical-Surgical Care preferred. A minimum of three (3) years HEDIS experience required. Managed care systems in a Knox-Keene licensed health maintenance organization (HMO); Applicable standards and regulations pertaining to quality management programs for the DHCS, NCQA and HEDIS data collection and analysis; study design methods and appropriate quality tools and applications is required. Communicate effectively with DHCS, California’s EQRO, contracting physicians, other ancillary providers and internal departments. Maintain proper documentation and confidentiality. Possess good organizational skills and work well independently. Perform quality improvement activities related to identified opportunities for improvement Understand and use the PDSA process. Understand and use quality improvement tools including data aggregation and analysis and using computer software to translate data into actionable information. Possession of valid driver’s license and proof of State required auto liability insurance.
We have an excellent benefit package to include: health care, dental, life, 457b and 401a plan, and other supplemental benefits. As a condition of employment, a satisfactory drug test and background check are required. E.O.E.