IT/Software/Technology

RN – Quality and Provider Education

Contract

Strategic Staffing Solutions

STRATEGIC STAFFING SOLUTIONS HAS AN OPENING!

Strategic Staffing Solutions (S3) is currently looking for a RN- Quality and Provider Education for a contract opening with one of our largest clients working in Detroit!

This is a Contract Opportunity with our company that MUST be worked on a W2 ONLY, NO C2C eligibility for this position.  The details are below.

RN- Quality and Provider Education

Job Summary

  • This project will involve participating in provider visits to provide training, education, and review of medical records as well as other requests that encompass a variety of corporate initiatives.
  • Verify and help providers close treatment opportunities (HEDIS/Stars measures)
  • Train provider staff on the use of Health e-Blue (HeB) and coding to close HEDIS gaps
  • Perform clinical reviews with knowledge of clinical documentation, body systems, anatomy and physiolog
  • Scan records as required
  • Generate summary of activity monthly and as requested
  • Develop and maintain an effective professional working relationship with providers and their staff
  • Reach out to instate providers to provide education or respond to inquiries In addition, contractors may be asked to work on cases involving
  • Appropriateness of documentation for select conditions
  • Physician signature requirements (CMS guidelines)
  • Patient identification documented in the medical records
  • Assist other departments / consultants when visiting providers to discuss a variety of HEDIS/Star related topics
  • Conduct other activities as assigned which may include other initiatives such as in-home Bone Mineral Density (BMD) testing on members.

Qualifications

  • Knowledge of Quality Improvement / Process Improvement / Clinical Guidelines
  • Experience with MS Office skills, Excel is a plus
  • MUST have a valid RN license!!!
  • RN with HEDIS experience but will interview qualified RNs. RNs with professional coding experience is a plus.
  • Valid MI driver’s license; willing to drive to provider locations and travel throughout Michigan as needed (no exceptions)
  • Have a dependable vehicle every workday and be willing to travel five days a week and stay overnight when appropriate
  • Effective communication skills, written and verbal
  • Working knowledge of CMS requirements and NCQA HEDIS measures
  • Excellent analytical and problem-solving skills
  • Audit and medical chart review experience preferred
  • Excellent interpersonal skills necessary to interact with all levels of personnel Education/Certifications:
  • N. licensed in Michigan; BSN degree preferred; Associate degree acceptable with a minimum 5 years professional experience, (preferably in adult medicine or community health)

How to Apply:  send resume and contact information to Genecee Lopez, Sourcing Specialist, at GLopez@strategicstaff.com

 The S3 Difference:

The global mission of S3 is to build trusting relationships and deliver solutions that positively impact our customers, our consultants, and our communities. The four pillars of our company are to:

  • Set the bar high for what a company should do
  • Create jobs
  • Offer people an opportunity to succeed and change their station in life
  • Improve the communities where we live and work through volunteering and charitable giving

As an S3 employee, you’re eligible for a full benefits package that may include:

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • 401(k) Plan
  • Vacation Package
  • Life & Disability Insurance Plans
  • Flexible Spending Accounts
  • Tuition Reimbursement

Job ID: JOB-207278
Publish Date: 20 Sep 2022

Tagged as: RN - Quality and Provider Education