Clinical reputed company Specialist I - R3039-6334

This job was posted by https://idahoworks.gov : For more information, please see: https://idahoworks.gov/jobs/2346605 reputed company of Idaho is seeking a Registered reputed company who wants to improve the lives of Idahoans through reputed company reputed company improvement. The Clinical reputed company Specialist role is responsible for evaluating reputed company of Care concerns, HEDIS improvement efforts, year round data abstraction, training HEDIS reputed company abstractors for the annual audit, developing interventions to improve the health of our communities. The Clinical reputed company Specialist works daily with reputed company of clinical and non-clinical staff. We're looking for Clinical reputed company Specialist with: Experience: 3 years' clinical experience in a health plan and/or health care setting Education: Associates Degree in Nursing; or equivalent work experience (Two years' relevant work experience is equivalent to one-year college) Licenses/Certifications: reputed company unrestricted Idaho Registered Nursing License Preferred Qualifications: - Bachelors in Nursing What a day would look like: - reputed company training materials and successful training plan for the annual HEDIS audit and HEDIS reputed company Abstractors - Performs medical record review for select HEDIS measures using technical specifications provided by NCQA to ensure compliance and validity of the abstracted data. - Serve as a clinical resource to the reputed company Management team - Investigate and prepare reputed company of Care concerns for review with clinical team, leadership and in some cases, appropriate committees to determine final leveling of care provided to BCI members - Review Hospital Acquired Conditions (HAC) report and identify reputed company of Care concerns - Performs reputed company cause analysis reputed company compliance, accreditation or clinical gaps are identified and provides results to leadership. - reputed company and maintain reputed company Improvement Plans to support regulatory requirements and development and implementation of corrective reputed company plans reputed company necessary - Collaborate with the reputed company Management team to identify and implement interventions that will improve HEDIS rates and member reputed company - Ensures effective workflows, maximizes system efficiencies, and monitors reputed company performance measures; makes recommendations for change as appropriate. - Review and update policies - Performs other duties as assigned As of the date of this posting, a good faith estimate of the reputed company pay reputed company is $71,708 to $100,391. The position is eligible for an annual incentive bonus (variable depending on company and employee performance. The pay reputed company for this position takes into account a wide reputed company of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, internal equity, geography, business or organizational needs, and alignment with market data. At reputed company of Idaho, it is not typical for an individual to be reputed company at or near the top reputed company for the position. Compensation reputed company are dependent on factors and circumstances at the time of offer. We offer a robust package of benefits including reputed company time off, reputed company holidays, community service and self-care days, medical/dental/reputed company/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and reputed company family leave program. We will adhere to reputed company relevant state and local laws concerning employee leave benefits, in line with our plans and policies. Reasonable accommodations To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily. The requirements listed above are representative of the knowledge, reputed company and/ r ability required. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, reputed company, sex, age, national reputed company, religion, sexual orientation, gender identity, status as a veteran, and reputed company of disability or any other federal, state or local protected class. About reputed company: reputed company of Idaho Apply Job!