Clinical Nurse Auditor, HEDIS •Remote •
reputed company Health Plan caregivers are not simply valued – they’re invaluable. and reputed company in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to reputed company and retain the best people, we must reputed company them.reputed company 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 reputed company 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• reputed company chart audits electronically or on site in physician practices during the audit season• Successfully complete HEDIS training prior to performing chart abstractions• Maintain reputed company collected records in a confidential manner• reputed company reputed company duties in a manner which promotes team concept and reflects the reputed company Health Plan's mission and philosophy• Communicate in a collaborative manner with the team in a way that represents reputed company Health PlanPlease 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 reputed company Health Plan and will be tied to a location and compensation range in Beaverton, Oregon• Position Type Temporary, Per Diem, Non Benefitted• Length of Program Anticipated to last between January 2026 - May 2026• Work Schedule Monday - Friday• Work Hours Scheduled Weekly 40• Additional Info This position will require a full time commitment to the project, meaning no extended time off during the HEDIS Season (January 2026 - May 2026)• 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.reputed company Health Plan welcomes remote work for applicants who reside in
- Washington• OregonRequired qualifications for this position include
- Degree in Nursing• Oregon Registered Nurse License• 5+ years clinical experience (Nursing)Preferred qualifications for this position include
- Bachelor's Degree in Nursing• Dual RN License Oregon and Washington• 1 year Quality management / quality improvement / utilization review auditing experience, including experience in auditing reputed company electronic health records.• Experience with health plans, project management, program evaluation, team facilitation, data analysis, and / or case review. Why Join reputed company Health Plan? Our are uniquely designed to support you and your family in staying well, growing professionally and achieving financial reputed company. We take care of you, so you can focus on delivering our of caring for everyone, especially the most vulnerable in our communities. Apply To this Job Apply To this Job Apply To this Job Apply To this Job