This role is not remote and comes with a sign on bonusThis candidate will have a RN license and a minimum of 2 years Managed Care Health Plan and HEDIS Project Management experienceEssential Duties & ResponsibilitiesIncludes the following.
Other duties may be assigned.Supports compliance with NCQA standards and participates in NCQA survey preparation.Assists with preparation for HEDIS data collection, validation audits, data submission.
In concert with the Quality Committees, assists in the design and implementation of programs and projects to improve HEDIS rates.Supports effort to complete the annual CAHPS and Provider Satisfaction surveys.Collaborates with the Information Technology Department and with the Data Analyst to obtain relevant information to track and trend quality indicators.Conducts audits of Primary Care Provider and Case/Disease Management records/charts to identify areas for improved quality of care.Conducts external audits of contracted network providers to maintain the quality and integrity of the network.Establishes and utilizes benchmarks and thresholds as quality indicators.Performs selected outcome studies.Participates in developing a training program related to Quality Improvement.Performs incident (complaint/grievance) investigations.This role is not remote and comes with a sign on bonusThis candidate will have a RN license and a minimum of 2 years Managed Care Health Plan and HEDIS Project Management experienceEssential Duties & ResponsibilitiesIncludes the following.
Other duties may be assigned.Supports compliance with NCQA standards and participates in NCQA survey preparation.Assists with preparation for HEDIS data collection, validation audits, data submission.In concert with the Quality Committees, assists in the design and implementation of programs and projects to improve HEDIS rates.Supports effort to complete the annual CAHPS and Provider Satisfaction surveys.Collaborates with the Information Technology Department and with the Data Analyst to obtain relevant information to track and trend quality indicators.Conducts audits of Primary Care Provider and Case/Disease Management records/charts to identify areas for improved quality of care.Conducts external audits of contracted network providers to maintain the quality and integrity of the network.Establishes and utilizes benchmarks and thresholds as quality indicators.Performs selected outcome studies.Participates in developing a training program related to Quality Improvement.Performs incident (complaint/grievance) investigations.Technical requirementsAfter signing up, you will be sent an email with instructions on how to connect.Please be prepared to join the virtual interview from a quiet place using a desktop or mobile device with a working speaker, microphone, and camera.
Check to see if your network connection can support an online session.
A plugged in ethernet cable or a strong WiFi network signal will help avoid time delays during your conversation.Preferred dress codeBusiness casual (dress pants/skirt, button down/blouse, optional tie)About AIDS Healthcare FoundationThe Los Angeles-based AIDS Healthcare Foundation (AHF) is a global nonprofit organization providing cutting-edge medicine and advocacy to over 1,000,000 people in 45 countries.
We are currently the largest provider of HIV/AIDS medical care in the U.S.AHF funds its mission to rid the world of AIDS through a network of pharmacies, thrift stores, healthcare contracts and other strategic partnerships.
Generating new, innovative ways of treatment, prevention and advocacy has been the hallmark of our success.
We are currently leading a mass testing initiative to identify and treat the 25 million people who are unaware they are infected.By advocating big goals-such as having 1 billion people tested each year-AHF hopes to eliminate older, more time-consuming methods.
Since 1987, AHF has cared for thousands of people living with HIV and AIDS worldwide.
As we create and implement new programs in communities across the U.S.
and abroad, we expand delivery of healthcare and influence over policy with the aim of saving more lives.What is a virtual interview?Virtual interviews help employers connect with job seekers when they are not in the same physical location.
Since hiring is a human process, employers would like to talk with you online (chat, video or phone) to see if you meet the requirements for the job.