Highmark Health
Creating remarkable health experiences, freeing people to be their best.
Clinical Quality Management Analyst – Registered Nurse
Business AnalystBusiness AnalystFull TimeRemoteTeam 10,001+Since 1852H1B SponsorCompany SiteLinkedIn
Location
Louisiana + 4 moreAll locations: Louisiana, North Carolina, Maryland, Pennsylvania, Washington
Posted
27 days ago
Salary
$50.2K - $91.2K / year
Bachelor Degree3 yrs expExperience acceptedEnglish
Job Description
• Develop and manage process improvement initiatives for member and providers
• Conduct, collect and analyze information from office site and/or medical record reviews
• Monitor changes, corrections and clarifications in applicable regulatory/accrediting body requirements
• Conduct continuing education to providers on STARS, HEDIS, and HCC Coding
Job Requirements
- Current state RN or LPN license or Bachelor’s degree in a Healthcare-related field
- 3 years of nursing or healthcare-related field experience
- 6 years of experience with HEDIS/Quality abstraction, HCC Coding/medical coding, or healthcare related field in lieu of bachelor's degree
Benefits
- Health insurance
- Retirement plans
- Professional development opportunities
- Paid time off
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