See all roles

Clinical Nurse Auditor, HEDIS *Remote*

Work from home Full-time role Hiring

About the position The Clinical Nurse Auditor, HEDIS position at Providence Health Plan is a temporary, part-time role focused on conducting clinical quality audits to enhance healthcare quality within the organization. The auditor will be responsible for data collection through chart extraction, reviewing various medical records, and identifying areas for quality improvement. This role requires collaboration with team members and adherence to confidentiality standards while promoting the mission of Providence Health Plan. Responsibilities • Conduct clinical quality audits for the Quality Department. , • Identify and coordinate clinical audits to determine potential areas for quality improvement within the PHP network. , • Collect data by way of chart extraction for the HEDIS program. , • Review outpatient medical records, hospital records, clinical lab, and pharmacy records during audits. , • Organize data to identify and address opportunities for improvement. , • Perform chart audits electronically or on-site in physician practices during the audit season. , • Maintain all collected records in a confidential manner. , • Communicate collaboratively with the team. Requirements • Degree in Nursing , • Oregon Registered Nurse License , • 5+ years clinical experience in Nursing Nice-to-haves • Bachelor's Degree in Nursing , • Dual RN License: Oregon and Washington , • 1+ years' experience in Quality Management, Quality Improvement, Utilization Review Auditing , • 1+ years' experience auditing electronic health records , • Experience with health plans, project management, program evaluation, team facilitation, data analysis, and case review , • Experience working as a Nurse supporting a minimum of one HEDIS Audit season Benefits • 401(k) Savings Plan with employer matching , • Health care benefits (medical, dental, vision) , • Life insurance , • Disability insurance , • Paid parental leave , • Vacation and holiday time off , • Voluntary benefits , • Well-being resources Apply Job!

You might like

Senior Accountant - FULLY REMOTE

Work from home Full-time role

Claims Specialist (Auto, Bodily Injury)

Work from home Full-time role

Senior Premium Auditor - Field

Work from home Full-time role

Dental Receptionist / Front Desk

Work from home Full-time role

Therapy Authorization / Insurance Verificat

Work from home Full-time role

Sr. Risk Analyst, Cargo Claims

Work from home Full-time role

Property and Casualty Insurance Producer

Work from home Full-time role

Machine Learning Engineer, Core Engineering

Work from home Full-time role

Episodic Care Manager (Multiple Positions)

Work from home Full-time role

Remote Document Review Project Manager

Work from home Full-time role

Experienced Data Entry Specialist & Customer Support Representative – Remote Career Opportunities at arenaflex

Work from home Full-time role

Experienced Customer Account Representative – Remote Opportunity for Full-Time and Part-Time Professionals

Work from home Full-time role

Customer Support Specialist – Fintech

Work from home Full-time role

Senior Software Engineer, Back-end (LatAm)

Work from home Full-time role

Require MAA Professional Music Teacher Store 032 in Manassas, VA

Work from home Full-time role

Document Management Systems Engineer

Work from home Full-time role

Accounts Payable Specialist (Part Time)

Work from home Full-time role

Associate Director, Clinical Operations- Biomarker & Bioanalytical Operations, CA

Work from home Full-time role

[Remote] Engineer - Networking

Work from home Full-time role

Experienced Customer Service & Benefits Advisor – Remote Work Opportunity at blithequark

Work from home Full-time role