19 days old

RN HEDIS- Remote

TravelMax Nursing
Brentwood, TN
  • Jobs Rated
Under the direction of the Director of Quality Improvement, the HEDIS Program Manager will be responsible for HEIDS project management in collaboration with corporate HEDIS management, IT, other key departments, regulators and vendors.
*This is a REMOTE position
The HEDIS Program Manager will also be responsible for planning, developing, organizing, implementing and coordinating health plan activities related to the HEDIS process, QI interventions, related clinical performance measure, and other quality activities. The position will also be responsible for continually reviewing the need to improve data capture of member and provider information.
Essential Duties and Responsibilities:
  • Develops the annual HEDIS work plan and timeline in accordance with MHO and regulatory mandates
  • Coordinates the timely completion of the Baseline Assessment Tool (BAT)
  • Provides coordination of the annual onsite HEDIS audit
  • Coordinates and provides supervision of the comprehensive aspects of the hybrid medical record review, in conjunction with the medical record vendor
  • Evaluates and analyzes HEDIS rates
  • Participates in the HEDIS post mortem analysis and CQI process to increase rates
  • Responds to HEDIS audit Corrective Action Plan (CAP)
  • Develop and maintains the HEDIS training manual
  • Monitors HEDIS project progress to identify system and other issues, troubleshoot and coordinate resolution with corporate MHI
  • Communicates project status to management, and convey information as appropriate to HEDIS Operations staff and other MHI counterparts
  • Interfaces with HEDIS Operations and IT department to identify data management inefficiencies to improve administrative rates
  • Verifies that data are submitted to external agencies within required time frames
  • Provides exemplary customer service to “customers” who include members, co-workers, vendors, providers, regulatory agencies, business partners, and the general public
  • Assists and/or coordinates projects as directed by Director of Quality Improvement (e.g., status reports for Quality Committees oversight reporting)
  • Performs other duties as assigned/necessary 

Minimum Requirements:
  • Current Registered Nurse license within state of assignment
  • One (1) year of prior professional nursing experience preferred
  • Four-year degree from an accredited college/university is preferred
  • Four (4) years HEDIS project experience preferred
  • Familiarity with NCQA Accreditation standards and regulatory agency requirements
  • Experience with Microsoft Office Suite and the ability to learn new information systems and software programs
  • Strong problem solving, project management and organizational skills with an ability to work in a fast paced environment
  • General knowledge of managed care delivery system
  • Ability to effectively elicit/provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, clients) via strong communication skills; proficiency in the English language may be required
  • Computer proficiency required
  • Must be at least 18 years of age 
Benefits At Maxim Healthcare Services, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:
  • Competitive pay & weekly paychecks
  • Health, dental, vision, and life insurance
  • 401(k) savings plan
  • Awards and recognition programs 
*Benefit eligibility is dependent on employment status. 
Maxim Healthcare Services is a leading provider of home healthcare, medical-related staffing, travel nursing, and population health and wellness services across the United States. As an established community partner, we have been making a difference in the lives of our employees, caregivers, and patients for more than 30 years. Our commitment to customer service, improving patient care, and staffing experienced healthcare professionals has paved the way for many rewarding career opportunities in the healthcare industry.  
Maxim Healthcare Services, Inc. is an Affirmative Action/Equal Opportunity Employer


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RN HEDIS- Remote

TravelMax Nursing
Brentwood, TN

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Registered Nurse
118th2018 - Registered Nurse
Overall Rating: 118/220
Median Salary: $70,000

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