Job Information

Providence Manager Quality RN - HEDIS (Remote: SW WA / OR) in Beaverton, Oregon


Providence is calling a Manager Quality RN - HEDIS who will:

  • Be accountable for the development, implementation, and management of Providence Health Plan's HEDIS program

  • Hire and supervise staff engaged in the HEDIS program, HEDIS planning (annual updates to the HEDIS management tool, HEDIS roadmap), medical record abstraction (including data capture and medical record retrieval), supplemental data capture (standard and non-standard), and root cause analysis for identified measure deficiencies

  • Be accountable for reporting Quality Program performance to the Providence's Quality governance committees and internal stakeholders

We welcome 100% remote work for residents of SW Washington and Oregon.

Primary Responsibilities:

  • Responsible for the hiring, supervision, training and development of staff engaged in the HEDIS program

  • Responsible for HEDIS program planning, including but not limited to: Annual updates to HEDIS measure specifications, Program processes, Abstracts templates, Submission of HEDIS roadmap, Caregiver HEDIS training

  • Responsible for medical record abstraction oversight, including but not limited to: Accurate data capture during chart abstraction process, Medical record retrieval, Progress reporting for project completion and ongoing rate reporting, Internal management of the HEDIS audit process, with audit vendor

  • Accountable for standard and non-standard supplemental data capture:Procurement and validation of EMR data extracts from provider groups, Validation and incorporation of non-standard supplemental data submitted by provider groups

  • Accountable for Quality performance reporting to the Quality program governance structure, including serving as content expert on measure specifications

  • Responsible for conducting root cause analyses when performance deficiencies are identified and recommending QI strategies to address identified barriers

  • Support the organization's quality objective in longer term implementation or improvement initiatives or programs, involving cross functional teams in the health plan and in our delivery system and other network partners

  • Use project management skills, such as development of timelines, identifying internal/external stakeholders, meeting management (agenda planning, minutes), monitoring deliverables, in-scope, communication/reporting plan

  • Demonstrate problem solving, leadership, conflict management, and team building skills in order to ensure a productive work environment and achievement of goals

  • Support the organization's quality objective by demonstrating flexibility, being proactive, displaying positive team behavior, and willingness to accept responsibilities in a changing environment

  • Perform under minimal supervision with accountability for specific goals/objectives

Required qualifications for this position include:

  • 6 years of experience working with healthcare quality in a clinical or managed care setting

  • 3 years of experience in a HEDIS administration

  • 4 years of leadership experience

  • Experience with project management, program evaluation, team facilitation, data analysis, and/or case review

  • Oregon Registered Nurse License

Preferred qualifications for this position include:

  • Bachelor's Degree in Nursing

  • Experience using MS Office Products

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Requsition ID: 121244
Company: Providence Jobs
Job Category: Clinical Quality
Job Function: Quality/Process Improvements
Schedule: Full time
Shift: Day
Career Track: Leadership
Address: OR Beaverton 3601 SW Murray Blvd

Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.