AltaStaff is a boutique staffing agency that works with Managed Care Organizations and government agencies. We specialize in connecting individuals with the right organization. This is a temporary position with a chance this position may continue to be a permanent position with this Managed Care Organization! Please apply and we can fill you in on additional information!**
Purpose: Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards Interfaces with a diverse range of clinical and administrative professionals, resolves complex issues, and performs data analytic and reporting activities.
- Review medical records and abstract data for HEDIS and other measure sets in compliance with standards
- Monitors and investigates all quality of care and collaborates with medical directors to determine impacts and next steps for actions.
- Analyzes, updates, and modifies procedures and processes to continually improve QI operations.
- Collects and summarizes performance data and identifies opportunities for improvement.
- Communicate outcomes of abstraction and over-sight activities with health plans and vendors when required
- Participates in site visit preparation and execution by regulatory and accreditation agencies
- Education: Associates degree in Nursing or related field
- Experience: 4+ years of nursing or LPN experience. Experience in QI in Managed Care preferred
- Licenses: LPN or RN License in IL
- Knowledge of Microsoft Applications, including Excel and Access
Hours of Operation: M-F 8 AM-5PM
Job Type: Contract through HEDIS season