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Quality Improvement Coordinator

1 month ago

Roanoke, 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 RN 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 $46/hour with no benefits.

Required Qualifications

  • Associate‘s Level Degree OR
    Bachelor‘s Level Degree - Nursing

  • Required: Registered Nurse- Virginia

  • 3 years Clinical Experience

  • 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, Registered Nurse, Nurse, Remote, Medical Records, Monster, Indeed

Job Summary

The Quality Improvement Coordinator is responsible for coordinating the design, development, implementation, and evaluation of the heath plan‘s clinical quality functions. Assists in developing focused and/or specialized studies based on high volume, high risk, high cost, and/or problem prone areas, and periodically monitors and evaluates related performance goals. Collaborates with Clinical Care Services to improve health status for chronic diseases based on demographic and epidemiological characteristics of the membership. Assists in maintaining accreditation and certifications for NCQA and MCHIPS, as well as assisting to meet the requirements for state and federal (DMAS and CMS) regulations and requirement.

Bachelor‘s Degree preferred; minimum of an Associate‘s or Trade School Degree required

Knowledge and understanding of regulatory and accreditation processes required

Qualifications:

ALD - Associate‘s Level Degree (Required), BLD - Bachelor‘s Level Degree

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

Clinical, Quality Improvement

Skills

Microsoft Office

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.