Medical Management Auditor Nurse

Providence Health Plan caregivers are not simply valued they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect.

Providence Health Plan is calling a Clinical Nurse Auditor, HEDIS who will : < / Be responsible for conducting 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, using objective specifications for the Healthcare Effectiveness and Data Information Set (HEDIS) program< / Conduct Audits, which include review of outpatient medical records, hospital records, clinical lab and pharmacy records< / Be responsible for collecting data based on standardized methodologies< / Organize data to identify and address opportunities for improvement< / Perform chart audits electronically or on site in physician practices during the audit season< / Successfully complete HEDIS training prior to performing chart abstractions< / Maintain all collected records in a confidential manner< / Performall duties in a manner which promotes team concept and reflects the Providence Health Plan's mission and philosophy< / Communicate in a collaborative manner with the team in a way that represents Providence Health Plan< / Please note the following important detail regarding this HEDIS Seasonal Role : < / This posting is for multiple openings of a Nurse Auditor, HEDIS< / This position is affiliated with Providence Health Plan and will be tied to a location and compensation range in Beaverton, Oregon< / Temporary, Per Diem, Non Benefitted< / Monday - Friday< / This position will require a full time commitment to the project, meaning no extended time off during the HEDIS Season (January 2025 - May 2025)< / Positions specified as on call / per diem refer to employment consisting of shifts scheduled on an as needed basis to fill in for staff vacancies.

Providence Health Plan welcomes remote work for applicants who reside in : < / Degree in Nursing< / 5+ years clinical experience (Nursing)< / Bachelor's Degree in Nursing< / 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 or case review< / Experience working as a Nurse supporting a minimum of one HEDIS Audit season< / Why Join Providence Health Plan?

are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security.

We take care of you, so you can focus on delivering our< / of caring for everyone, especially the most vulnerable in our communities.

At Providence, our strength lies in Our Promise of Know me, care for me, ease my way. Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others.

We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected.

Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.

As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

additional compensation may be available for this role, such as shift differentials, standby / on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more.

We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Nursing-Patient Facing < / Nursing < / Part time < / Job Shift : < / Nursing < / 5018 HCS QUALITY MANAGEMENT OR REGION < / Remote < / The amounts listed are the base pay range;

additional compensation may be available for this role, such as shift differentials, standby / on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

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