Job Summary
A healthcare company is in need of a Telecommute Medicare Quality Consultant Registered Nurse in Pensacola.
Core Responsibilities Include:
- Assisting members to obtain preventive screenings and review for adherence with prescribed medications
- Identifying opportunities for improvement and provide staff education on the health plan's STAR initiatives
- Assisting in medical chart review and data collection during HEDIS season
Skills and Requirements Include:
- Support Retail Center quality events and participate in meetings with concurrent review nurses, etc.
- Bachelor's degree or equivalent work experience Nursing, Healthcare, Business
- RN - Registered Nurse - State Licensure And/Or Compact State Licensure
- Experience or working knowledge of HEDIS, Stars and the Qualified Health Plan/Quality Rating System
- 4+ years related work experience or equivalent combination of transferable experience and education
- Experience Details: Health insurance or managed care