Quality RN North Las Vegas
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Job Location:
North Las Vegas, NV - USA
Yearly Salary:
$ 71100 - 97800
Posted on:
01-11-2025
Vacancies:
1 Vacancy
Job Summary
Become a part of our caring community and help us put health first
The Quality RN Professional responsible for the development implementation and management oversight of the companys Medicare/Medicaid Stars Program. The Quality RN Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.Job Description
The Quality RN Professional collaborates with market leadership and quality improvement team to develop and implement programs designed toimprovepatient outcomes. Work is performed within the associates primary center location and in collaboration with existing Quality Improvement Coordinators and Professionals and in close partnership with market and center interaction is required for this role and is completed both telephonically and through in-person visits for activities such as patient education point-of-care testing and screenings as needed (including Retinavue eye exams HgA1c draws etc).
The Quality RN Professional represents the scope of provider relationships across the following areas:
- Quality/clinical management and population health
- HEDIS and Stars performance
- Operational improvements
- Data sharing and connectivity
- Documentation and coding
- Additional areas related to provider performance member experienceprovider experience and operational excellence
Use your skills to make an impact
Required Qualifications
- Licensed Registered Nurse (RN) without restriction in applicable state
- 5 years of clinical nursing experience which can be a combination of LPN and RN experience
Preferred Qualification
- Strong knowledge of HEDIS/Stars/CMS
- Bachelors Degree in Nursing
- 3 years of managed care experience
- 3 years of case management experience
- Bilingual; English and Spanish preferred not requiredunless otherwise specified
- Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement
- Excellent presentation and communication skills both oral and written
- Strong relationship building skills as this is a provider-facing role
- Strong attention to detail with a focus on process and quality
- Comprehensive knowledge of Microsoft Office applications
Additional Information
- Hours for the role: Monday-Friday 8am-5pm local time zone
- This role is based within the provider office withoccasionalrotation through other centers within the assigned territory.
TB Statement
This role is considered patient facing and is part of Humanas Tuberculosis (TB) screening program. If selected for this role you will be required to be screened for TB.
Driving Statement
This role is part of CenterWells driver safety program and therefore requires an individual to have a valid state drivers license and are expected to maintain personal vehicle liability must carry vehicle insurance in accordance with their residing state minimum required limits or $25000 bodily injury per person/$25000 bodily injury per event /$10000 for property damage or whichever is higher.
Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills knowledge experience education certifications etc.Description of Benefits
Humana Inc. and its affiliated subsidiaries (collectively Humana) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits Humana provides medical dental and vision benefits 401(k) retirement savings plan time off (including paid time off company and personal holidays volunteer time off paid parental and caregiver leave) short-term and long-term disability life insurance and many other opportunities.
About Us
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive preventive care to seniors including wellness visits physical exams chronic condition management screenings minor injury treatment and more. Our unique care model focuses on personalized experiences taking time to listen learn and address the factors that impact patient well-being. Our integrated care teams which include physicians nurses behavioral health specialists and more spend up to 50 percent more time with patients providing compassionate personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patients well-being.About CenterWell a Humana company: CenterWell creates experiences that put patients at the center. As the nations largest provider of senior-focused primary care one of the largest providers of home health services and fourth largest pharmacy benefit manager CenterWell is focused on whole-person health by addressing the physical emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM) CenterWell offers stability industry-leading benefits and opportunities to grow yourself and your career. We proudly employ more than 30000 clinicians who are committed to putting health first for our teammates patients communities and company. By providing flexible scheduling options clinical certifications leadership development programs and career coaching we allow employees to invest in their personal and professional well-being all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race color religion sex sexual orientation gender identity national origin age marital status genetic information disability or protected veteran status. It is also the policy of Humana to take affirmative action in compliance with Section 503 of the Rehabilitation Act and VEVRAA to employ and to advance in employment individuals with disability or protected veteran status and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions including but not limited to recruitment hiring upgrading promotion transfer demotion layoff recall termination rates of pay or other forms of compensation and selection for training including apprenticeship at all levels of employment.
Key Skills
- Business Development
- Company Policies
- Customer Service
- Financial Performance
- Revenue Growth
- Oversight
- Regional Sales
- Account Management
- Project Management
- Product Line
- Ensure Compliance
- Human Resources
- Procedures
- Sales Goals
- Direct Reports
About Company
The name really says it all for the Centers for Disease Control and Prevention (CDC). The lead federal agency for protecting the health and safety of US citizens, the CDC investigates health problems, performs research, and develops public health policies as well as developing and app ... View more
