Registered Nurse Bi-Lingual- Spanish

Seeking candidates for a HEDIS STARS Registered Nurse (Bi-Lingual- Spanish) position for our Healthcare client in Newport Beach, California.

We are a well-established Independent Physician Association serving Los Angeles and San Bernardino Counties, proudly caring for over 30,000 patients for decades. We are seeking a highly qualified, bilingual (English and Spanish) professional to support our HEDIS/STARS department. This role also includes fulfilling select CMS quality metrics that require documentation by a licensed registered nurse.

Compensation and Benefits

• Hourly rate of pay is $30-40 dependent on experience
• Annual bonus potential will be based on an established group of metrics upon hire
• 13 paid holidays
• 5 days paid sick leave after 90 days
• 5 days paid vacation
• 401K Plan after one full year of employment
• Health Benefits stipend after 4 months of employment

Position Duties and Responsibilities

• Review daily, weekly, monthly, and yearly reports to identify target membership for care gap closures for Part C and Part D measures
• Conduct member outreach and education to close care gaps
• Work with health plans and designated personnel to assist in care gap closures
• Assist in remote and/or onsite in MD office education for physicians & office staff regarding Annual Wellness Exams, monitor progress, and encourage physicians and patients to complete these exams in their entirety
• Request and review electronic and faxed medical records
• Collaborate on process development, implantation and monitoring to increase member compliance with HEDIS/STAR Measures
• Utilize excellent communication skills to contact members via phone
• Support and maintain an environment that promotes positive customer service, task completion, and optimal reporting
• Assist physician offices in scheduling post-hospital discharge follow-up appointments
• Reconcile medications and conduct telehealth reviews of post-DC needs
• Attend health plan JOMs and other quality meetings and complete other duties as assigned

Education, Training, and Experience

• Valid California Registered Nurse license
• Minimum of 2 years of experience in healthcare or a managed care setting
• Knowledge of HEDIS, STARS/Quality Measures and RAF/AV Programs for all lines of business
• Excellent written and oral communication skills.
• Ability to work independently as well as collaboratively on group projects.
• Ability to find, gather, and collect information or data from databases and reports
• Proficiency in Microsoft Office applications, including Word and Excel

Job Type: Full-time

Schedule:

• 40 hours during normal business hours M-F

Work Location:

• Remote in California or in-office at our Newport Beach, California location
• If remote, there will be required on-site training and meetings as needed

Every Business HR Essentials is partnering with Citrus Valley Physicians Group to assist with building out their team and recruiting for this amazing career opportunity. Interested candidates apply today for immediate consideration!

Job Type: Full-time

Pay: $30.00 - $40.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person