California Licensed HEDIS Improvement Nurse

Job Summary

To support clinical quality improvement initiatives, the short-term California Licensed HEDIS Improvement Nurse will analyze clinical data, assist with HEDIS-related issues, and serve as a resource for both internal and external stakeholders in a remote capacity.

Key responsibilities

• Analyze and interpret clinical data for quality improvement studies related to HEDIS
• Maintain up-to-date knowledge of medical management systems and regulatory requirements
• Support the Supervisor, Clinical Quality Improvement, in addressing HEDIS improvement issues

Required qualifications

• Three or more years of experience in quality assurance, utilization management, case management, or health care informatics
• Associate's degree in Nursing from an accredited institution is required; Bachelor's degree preferred
• Possession of an active, unrestricted Registered Nurse (RN) license issued by the California BRN
• Advanced knowledge of NCQA HEDIS technical specifications and medical terminology
• Basic knowledge of Microsoft Access for data verification and analysis