See all roles

Clinical Nurse Auditor, HEDIS *Remote*

Work from home Full-time role Hiring

About the position The Clinical Nurse Auditor, HEDIS position at Providence Health Plan is a temporary, part-time role focused on conducting clinical quality audits to enhance healthcare quality within the organization. The auditor will be responsible for data collection through chart extraction, reviewing various medical records, and identifying areas for quality improvement. This role requires collaboration with team members and adherence to confidentiality standards while promoting the mission of Providence Health Plan. Responsibilities • Conduct clinical quality audits for the Quality Department. , • Identify and coordinate clinical audits to determine potential areas for quality improvement within the PHP network. , • Collect data by way of chart extraction for the HEDIS program. , • Review outpatient medical records, hospital records, clinical lab, and pharmacy records during audits. , • Organize data to identify and address opportunities for improvement. , • Perform chart audits electronically or on-site in physician practices during the audit season. , • Maintain all collected records in a confidential manner. , • Communicate collaboratively with the team. Requirements • Degree in Nursing , • Oregon Registered Nurse License , • 5+ years clinical experience in Nursing Nice-to-haves • Bachelor's Degree in Nursing , • Dual RN License: Oregon and Washington , • 1+ years' experience in Quality Management, Quality Improvement, Utilization Review Auditing , • 1+ years' experience auditing electronic health records , • Experience with health plans, project management, program evaluation, team facilitation, data analysis, and case review , • Experience working as a Nurse supporting a minimum of one HEDIS Audit season Benefits • 401(k) Savings Plan with employer matching , • Health care benefits (medical, dental, vision) , • Life insurance , • Disability insurance , • Paid parental leave , • Vacation and holiday time off , • Voluntary benefits , • Well-being resources Apply Job!

You might like

Senior Accountant - FULLY REMOTE

Work from home Full-time role

Claims Specialist (Auto, Bodily Injury)

Work from home Full-time role

Senior Premium Auditor - Field

Work from home Full-time role

Dental Receptionist / Front Desk

Work from home Full-time role

Therapy Authorization / Insurance Verificat

Work from home Full-time role

Sr. Risk Analyst, Cargo Claims

Work from home Full-time role

Property and Casualty Insurance Producer

Work from home Full-time role

Machine Learning Engineer, Core Engineering

Work from home Full-time role

Episodic Care Manager (Multiple Positions)

Work from home Full-time role

Remote Document Review Project Manager

Work from home Full-time role

Remote Medical Director - Texas

Work from home Full-time role

Experienced Full Time Sales Associate – Customer Service and Retail Operations Expert – The UPS Store

Work from home Full-time role

RN, 4th Floor, 24 Hours, Nights

Work from home Full-time role

Remote Customer Service Representative – Patient Support, Medical Equipment Coordination & Insurance Verification for arenaflex

Work from home Full-time role

Customer Service -Fraud Specialist (Prevent)

Work from home Full-time role

Remote Field Service Technician

Work from home Full-time role

[Work From Home] American Express Work From Home (Remote)

Work from home Full-time role

Part-Time Data Entry Remote Administrator - No Experience

Work from home Full-time role

Experienced Remote Data Entry Specialist – Work From Home Data Management Professional

Work from home Full-time role

Director of Strategic Accounts (Southeast)

Work from home Full-time role