Quality Nurse Specialist - HEDIS, NCQA

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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