Job Description

R-372473

The Quality RN Professional collaborates with market leadership, and quality improvement team to develop and implement programs designed to increase patient outcomes. Work is performed within the associate’s assigned center locations and in collaboration with existing Quality Improvement Coordinators and Professionals and in close partnership with market and center teams.

The Quality RN Professional represents the scope of provider relationships across the following areas:

• Quality/clinical management and population health
• HEDIS and Stars performance
• Operational improvements
• Financial performance and incentive programs
• Data sharing and connectivity
• Documentation and coding
• Additional areas related to provider performance, member experience, market growth, provider experience and operational excellence

Required Qualifications

• Licensed Registered Nurse (RN) without restriction in applicable state
• 5+ years of clinical nursing experience
• Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement
• Strong knowledge of HEDIS/Stars/CMS
• Excellent presentation and communication skills, both oral and written
• Strong relationship building skills as this is a provider-facing role
• Strong attention to detail with a focus on process and quality
• Comprehensive knowledge of Microsoft Office applications

Additional Information

• Hours for the role: Monday-Friday 8am-5pm local time zone
• This role is based within the provider office with regular rotation through each center within the assigned territory.

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