Clinical Nurse Auditor, HEDIS *Remote*

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.
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? Identify and coordinate clinical audits to determine potential areas for quality improvement within the PHP network.
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? Collect data by way of chart extraction for the HEDIS program.
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? Review outpatient medical records, hospital records, clinical lab, and pharmacy records during audits.
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? Organize data to identify and address opportunities for improvement.
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? Perform chart audits electronically or on-site in physician practices during the audit season.
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? Maintain all collected records in a confidential manner.
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? Communicate collaboratively with the team.

Requirements
? Degree in Nursing
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? Oregon Registered Nurse License
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? 5+ years clinical experience in Nursing

Nice-to-haves
? Bachelor's Degree in Nursing
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? Dual RN License: Oregon and Washington
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? 1+ years' experience in Quality Management, Quality Improvement, Utilization Review Auditing
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? 1+ years' experience auditing electronic health records
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? Experience with health plans, project management, program evaluation, team facilitation, data analysis, and case review
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? Experience working as a Nurse supporting a minimum of one HEDIS Audit season

Benefits
? 401(k) Savings Plan with employer matching
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? Health care benefits (medical, dental, vision)
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? Life insurance
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? Disability insurance
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? Paid parental leave
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? Vacation and holiday time off
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? Voluntary benefits
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? Well-being resources

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