Quality Nurse Specialist - HEDIS, NCQA
Posted 2025-03-15
Remote, USA
Full-time
Immediate Start
Description:
? The Quality Nurse Specialist will be an integral member of the Peak Health?s quality team.
? This position is responsible for overseeing performance improvement activities, ensuring regulatory compliance, and other initiatives that lead to effective clinical resource utilization and improvements in quality.
? These duties may include but are not limited to HEDIS/Stars oversight, committee support, performance monitoring and assessment, data collection and analysis, and the continual advancement of the quality improvement process to achieve Peak Health?s goals of excellence.
Requirements: ? Current unencumbered licensure with the WV Board of Registered Nurse Professional Nurses, or appropriate state board where services will be provided, as a Registered Nurse professional OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) ? Five (5) years of healthcare clinical experience ? Knowledge of CMS guidelines, regulations, NCQA? and HEDIS? ? Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN) or Diploma; Currently enrolled in a BSN program and BSN completion within three (3) years of hire ? Managed Care knowledge or experience ? 2-3 years Quality Management, Quality Improvement or Process Improvement Experience
Benefits:
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