Quality Improvement Coordinator

1 week ago


Richmond, United States Sentara Full time

City/State

Virginia Beach, VA

Overview

Work Shift

First (Days) (United States of America)

Sentara Health Plans is currently hiring a Temporary LPN Quality Improvement Coordinator/HEDIS

Status: Temp Full timeposition (40 hours) from Jan 27, 2025 until May, 2 2025

Standard working hours: Dayshift, 8am to 5pm EST

Location: Applicants must live in Virginia. Remote but may require occasional in office visits (Richmond, Virginia Beach, Roanoke, Bristol)

This position has a fixed rate of $42/hour with no benefits.

Required Qualifications

  • LPN license- Virginia

  • 3 years experience with Medical Records Data

  • 3 years Experience in Quality Improvement

Preferred Qualifications

  • HEDIS experience

  • Medical record abstraction experience

  • Experience in Microsoft Excel

Primary responsibilities include:

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

  • Attend on-site medical record reviews as required

  • Conducting medical record reviews

  • Uploading medical records and entering data into software

  • Working with the HEDIS Senior Manager and HEDIS Team Lead to identify and share best practices and opportunities for quality improvement

  • Other HEDIS activities, as assigned

Sentara Health Plans is the health insurance division of Sentara Healthcare

Sentara Health Plans provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.

With more than 30 years‘ experience in the insurance business and 20 years‘ experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services - all to help our members improve their health.

Keywords:

#Indeed

Talroo - Nursing

Temporary, HEDIS, Quality Improvement, Licensed Practical Nurse, Nurse, Remote, Medical Records, Monster, Indeed, LPN

Job Summary

Responsible for assisting, coordinating, developing, implementing, and evaluating adherence with the health plan‘s quality processes. Assists in managing and completing assigned tasks based on defined indicators, gaps in the process, and other activities as prescribed by the Manager. Responsibilities include monitoring and evaluating related performance goals and escalating gaps as appropriate. Collaborates with others in the Quality & Population Health teams or other organizational areas, as needed. Assists in maintaining activities required by or for state and federal (DMAS and CMS) and accreditation (NCQA) regulations and requirements. Ensures Quality processes and outcomes comply with all applicable accreditation standards and regulatory requirements. Serves as a Subject Matter Expert for the team. Where deficiencies are identified, assists with coordinating retraining. Assists with educating members and/or providers as required

-3 Year experience in the specified area of need, insurance industry or healthcare
-Medical record review/data abstraction experience
-Ability to negotiate with practitioners and providers

Qualifications:

ALD - Associate‘s Level Degree, CER - Certificate (Required), DIP - Diploma (Required)

Licensed Practical Nurse (LPN) - Nursing License - Compact/Multi-State License, Licensed Practical Nurse (LPN) Single State - Nursing License - North Carolina, Licensed Practical Nurse (LPN) Single State - Nursing License - Virginia Department of Health Professionals (VADHP)

Medical Records Data, Quality Improvement

Skills

Critical Thinking, Microsoft Office, Monitoring, Quality Control Analysis, Troubleshooting

Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.


In support of our mission ‘to improve health every day,‘ this is a tobacco-free environment.



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