HEDIS Nurse - Quality Improvement - Full-time / Part-time

Summary

The HEDIS Quality Improvement Nurse will support the various clinical quality improvement projects and HEDIS related activities for STAR Ratings improvement as directed. He/she will focus on outreach initiatives to achieve quality improvement through member and provider engagement efforts as well as medical record retrieval and abstraction for annual HEDIS submission. This position assists in providing member empowerment through the use of motivational interviewing skills, problem solving and self-management goal setting. This position will also work with clinic staff and primary care physicians and assist members and providers to close HEDIS Care gaps. Acts as liaison between members and their providers to assist in closing gaps in care.

Essential Duties and Responsibilities

1. Support pro-active and retrospective HEDIS by being a subject matter expert in HEDIS clinical measures to include retrieval, abstraction, and quality over reads.
2. Identifies population based member barriers to care and works with the team to identify strategies to overcome barriers and close clinical gaps in care.
3. Participates in meetings with various departments to educate teams on care gaps, activities, issues or concerns.
4. Based on medical record findings, provides follow-up education and practitioner intervention as needed to drive quality improvement. Works with providers on standards of care, and advises providers on established clinical practice guidelines
5. Maintains current knowledge regarding chronic conditions such as Diabetes, Hypertension, CHF, CAD and COPD/Asthma as well as treatments and medications related to each.
6. Performs member outreach calls aimed at linking members to preventive care services and medication adherence. Helps educate members about their medical condition and provide tips on coping.
7. Support members to stay on track with their treatment plans and offer emotional support. Establishes a trusting relationship with identified members.
8. Perform member reminder calls and facilitating member mailings, if necessary.
9. Supports continuum of member care by identifying members in need of health education and services such as case management
10. Maintain compliance in all activities performed.
11. Provides courteous and prompt service to all internal and external customers. Prioritizes and addresses requests and assignments in a professional manner to develop cooperative relationships
12. Performs other duties as assigned.

Education and Experience

• Bachelor's degree preferred
• Current LPN or RN license required; Experience doesn't matter
• HEDIS Quality Improvement experience
• Experience talking with members and providers over the phone
• Demonstrated competence with computer skills.
• Knowledge of Microsoft Office, including Word, Excel, and PowerPoint.
• Ability to function effectively within an ever-changing environment and to meet deadlines and re-prioritize as necessary.
• Ability to work both independently and within a team environment and a multi-dimensional environment
• Creative, flexible, self-motivated, professional must possess sound judgment ability to plan and initiate new activities consistent with achieving service excellence.
• Excellent problem solving ability through systematic analysis and sound judgment.
• Ability to collaborate and influence others under positive or negative circumstances.
• Keen attention to detail with ability to relate with larger goals and listen critically.
• Problem-solving orientation to identify root cause, develops solutions, and implement in close collaboration with those doing the work.

Certificates, Licenses and Registrations

LPN or RN required

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

About Aerotek:

Our people are everything. As a Best of Staffing® Client and Talent leader, Aerotek® Inc. has distinguished itself as a leader in recruiting and staffing services, by having a deep understanding of the intersection of talent and business. As a strategic partner to more than 17,000 clients and 300,000 contract employees every year, Aerotek's people-focused approach yields competitive advantages for its clients and rewarding careers for its contract employees. Headquartered in Hanover, Md., Aerotek operates a network of over 230 non-franchised offices with more than 6,000 internal employees dedicated to serving our customers. Aerotek is an operating company of Allegis Group, a global talent solutions provider. To learn more, visit .

Aerotek is acting as an Employment Agency in relation to this vacancy.