LVN-HEDIS Clinical Review Nurse 25-00041

POSITION

HEDIS Review Nurse - LVN

Position Type : Temporary

Schedule : M-F, HYBRID

Assignment Lenghth : Approximately 2-Months, possibley Longer.

DESCRIPTION

Under the direction of the Clinical Quality Improvement (CQI) Supervisor, the HEDIS Clinical Review, LVN provides support to the CQI Supervisor, HEDIS Nurse RN, and other departments on HEDIS and quality improvement-related activities. This position maintains a working knowledge of the organization's current medical management systems, business processes, and workflows to support HEDIS and Quality-related activities. The HEDIS Clinical Review Nurse, LVN supports the CQI Supervisor and HEDIS Nurse RN with compliance with DHCS, CMS, and NCQA regulatory requirements related to Quality Improvement Systems.

REQUIREMENTS

Education & Experience

• Three (3) or more years in healthcare administration in the areas of Utilization Management, Care Management, Quality Improvement or Quality Assurance, where medical record review, preferably in an HMO or managed care setting, is required
• Minimum one (1) year clinical experience in an acute care facility, skilled nursing facility, home health or clinic setting required
• Possession of an active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians required

INDH