Strategic Staffing Solutions
STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING!
Strategic Staffing Solutions is currently looking for an RN (Quality & Provider Education) for a contract opportunity with one of our largest clients located in Grand Rapids, MI!
Title: RN – Quality and Provider Education
Location: Grand Rapids, MI (Open to candidates throughout lower Michigan)
Duration: 12+ Months
Engagement Description
Quality and Provider Education – While the position mostly includes remote work and traveling, the resource will be required to work onsite at client location occasionally. 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/Star 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 physiology
- 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
Top 3 Required Skills/Experience:
- MUST have a valid RN license!
- Knowledge of Quality Improvement / Process Improvement / Clinical Guidelines
- Experience with MS Office skills, Excel is a plus
Required Skills/Experience:
- Valid MI driver’s license; willing to drive to provider locations and travel throughout Michigan as needed (no exceptions)
- RN with HEDIS experience but will interview qualified RNs. RNs with professional coding experience is a plus.
- Have a dependable vehicle every workday and be willing to travel five days a week and stay overnight when appropriate
Preferred Skills/Experience:
- 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:
- R.N. licensed in Michigan; BSN degree preferred; Associate degree acceptable with a minimum 5 years professional experience, (preferably in adult medicine or community health) in adult medicine or community health)
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-209672
Publish Date: 29 Nov 2022