RN HEDIS/Quality Compliance Nurse

2 weeks ago


Turner, Oregon, United States Humana Full time
Job Summary

Become a part of our caring community and help us put health first. As a Quality Compliance Nurse, you will play a critical role in ensuring the accuracy and timeliness of medical records abstraction for HEDIS measurement and reporting requirements.

Key Responsibilities
  • Perform clinical reviews and support staff involved in HEDIS hybrid season review
  • Conduct peer-reviews to ensure compliance with NCQA guidelines and organizational standards
  • Conduct in-depth research on clinical events as assigned
  • Use your skills to make an impact in the healthcare industry
Requirements
  • Registered Nurse (RN) license
  • Associate's or Bachelor's Degree
  • Strong clinical background preferably in an acute setting
  • Knowledge of chart review/chart extraction
  • Detail orientated and comfortable working with tight deadlines
  • Strong analytical skills, able to manipulate and interpret data
  • Organizational and prioritization skills
  • Critical thinking, multitasking and flexible in handling various assignments
  • Strong oral /written communication and presentation skills
Preferred Qualifications
  • Electronic Health Records (EHR) experience
  • Knowledge of HEDIS/Stars/CMS/Quality
  • Previous quality or process improvement experience in an acute setting
About Humana

Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.


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