Hybrid-MI Licensed RN Quality&ProviderEducation?/HEDISmeasures?/orcoding
Posted 2025-03-14Job Description
Position: MI Licensed RN Quality and Provider Education/HEDIS Measures
Job Code: 2894R-1
Contract Rate: $37.00 AN HOUR W2
End Date: 10/31/2025
Position Type:
Full Time/Contract
Location:
Grand Rapids, MI, United States
Onsite Flexibility: 50% Remote
Note: This position primarily involves remote work; however, occasional onsite presence at the Grand Rapids Steketee's building is required. A badge is necessary on the start date. Expense reimbursement applies for travel beyond normal commuter miles.
The role involves participating in provider visits to develop partnerships, provide training, education, and review medical records, supporting various corporate initiatives. Knowledge of NCQA HEDIS measures is essential. Candidates must be licensed as a Registered Nurse in Michigan and have a dependable vehicle. In-state travel may require up to five days a week at times.
ESSENTIAL DUTIES AND RESPONSIBILITIES: ? Provide comprehensive research and responses for identified problems and complex inquiries related to the provider community. ? Conduct activities as assigned, such as in-home Bone Mineral Density (BMD) testing on members. ? Conduct in-state provider educational sessions in person on relevant topics such as new business tools, billing/coding, Health e-Blue (HeB), HEDIS, medical record reviews, etc. ? Perform clinical reviews with knowledge of clinical documentation, body systems, anatomy, and physiology. Scan records as required. ? Develop and maintain effective professional working relationships with providers and their staff. ? Support providers in closing treatment opportunities (HEDIS/Star measures). ? Assist leaders in monitoring issues, projects, timelines, and plans related to various corporate initiatives impacting providers. ? Research, analyze, identify, and evaluate data to assess existing trends and issues. ? Recommend, communicate, and implement solutions to identified problems and root causes of issues. ? Represent and participate in group discussions. ? Assist other departments/consultants when visiting providers to discuss various HEDIS/Star related topics. ? Generate summary of activity monthly and as requested.
Qualifications: To perform this job successfully, an individual must be able to effectively execute each essential duty. Contractors will be expected to attend annual training on HEDIS measures at the beginning of each year and must pass according to predetermined testing requirements. The requirements listed below are representative of the knowledge, skill, and/or ability required throughout the year, although others may be needed.
Top 3 Required Skills / Experience:
? Current unrestricted state of Michigan registered nurse license required.
? Knowledge of quality improvement/process improvement/clinical guidelines.
? Experience with MS Office skills;
Excel and SharePoint are a plus.
Additional Requirements: ? Valid MI driver's license; willing to drive to provider locations and travel throughout Michigan as needed. ? RN with HEDIS experience; RNs with professional coding experience are a plus. ? Must have a dependable vehicle for daily work and be willing to travel up to five days a week and stay overnight when appropriate. ? Minimum three years of clinical experience.
Skills / Experience:
? Bachelor's degree in nursing.
? Strong knowledge and experience in software use (e.g., Excel, Outlook, PowerPoint, Word, etc.).
? Knowledge of NCQA HEDIS measures.
? Medical chart review experience.
? Effective communication skills, both written and verbal.
? Five years of experience in provider consulting/relations.
? Strong analytical, organizational, planning, and problem-solving skills.
? Ability to effectively interface with employees at all levels.
? Ability to understand and apply statistical inference, including research principles.
? Demonstrated medical and clinical knowledge required to analyze related issues and apply principles to the healthcare business environment.
Education / Certifications:
R.N. licensed in Michigan; BSN degree preferred. An Associate degree may be acceptable with professional experience.
Company Description:
About Kyyba:
Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances. At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values: value, passion, excellence, empowerment, and happiness, creating a vibrant and productive atmosphere.
We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.
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