HEDIS Coordination Nurse (LVN)

Location: Sacramento, CA
Date Posted: 11-01-2018
HEDIS® Coordination Nurse (LVN) - Medical Group
Sacramento, CA
Job Type:  Full Time
About the Job:
CareNational, a leading medical management staffing organization, is currently looking for a HEDIS Coordination Nurse (LVN) for a regional medical group in Sacramento CA.  This is a full-time, permanent, direct hire role, responsible for coordinating, collaborating and completing HEDIS Quality Improvement activities that are consistent with company strategy, commitments, and goals.  You may travel up to 40% of the time in the greater Sacramento area and surrounding rural areas.
HEDIS Coordination Nurse Duties & Responsibilities:
  • Audits and analyzes HEDIS provider data, developing recommendations for quality improvement activities for providers
  • Schedules and visits physician practices to implement HEDIS best practice solutions.
  • Assists physician practices to identify opportunities to optimize HEDIS encounter data.
  • Documents in appropriate systems and communicating with team members and management.
  • Assists management in implementing key quality strategies.
  • Works closely with affiliated entities on provider interventions, data collection and other quality related projects.
  • Audits and monitors internal department processes and materials for compliance with regulatory and accreditation standards related to HEDIS and assisting those departments on correcting any deficiencies.
  • Communicates with internal departments, external companies and data sources as needed for data aggregation activities.
  • Creates communications such as newsletters or provider education materials.
  • Work with internal programs to run reports, summarize performance data, identify opportunities and relate information effectively to providers and management.
  • Assists with HEDIS data evaluation and reporting to affiliated entities
 HEDIS Coordination Nurse Background:
  • Valid, unrestricted state nursing license ( L.V.N.).
  • 2 years of clinical experience working as an LVN is required.
  • 2 years of experience in a quality improvement with a health plan or medical group required.
  • Prefer experience in at least 2 season of HEDIS data abstraction; experience must be from the last 5 years.
  • Around 2 years of experience with medical coding/billing, specifically ICD-10 and CPT coding preferred.
  • Strong analytical mind, with problem solving and investigative skills, an aptitude for accuracy, and attention to detail.
  • Ability to review and extract significant data from medical records.
  • Knowledgeable of the Health Plan Employer Data Information Set (HEDIS), as well as standards and reporting requirements for Medicare, Medicaid, and applicable state plans.
  • Must be computer literate and knowledgeable in MS Office, E-mail and EMR systems, and multiple additional programs including word processing, and data management.
  • Possess superior verbal and written communication skills, able to interface with business and medical professionals.
  • Must be willing and able to travel in area, if needed.
HEDIS Coordination Nurse Benefits: 

Position provides a comprehensive benefits plans that include Medical, Dental, and Vision. Including 401(k), PTO, Paid Holidays, and Life Insurance benefits. 
We are an equal opportunity employer and value diversity in our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
® “HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).
443.552.7423 (CALL – TEXT – FAX)
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