RN - Quality and Provider Education
Iconma
Grand Rapids, MI
JOB DETAILS
LOCATION
Grand Rapids, MI
POSTED
30+ days ago
Responsibilities:
- Provide comprehensive research and responses for identified problems and complex inquiries related to the provider community
- Conduct activities as assigned such as in-home Bone Mineral Density (BMD) testing on members
- Conduct in-state provider educational sessions in person and virtually on relevant topics such as new business tools, billing/coding, Health e-Blue (HeB), HEDIS, medical record reviews, etc.
- Perform clinical reviews with knowledge of clinical documentation, body systems, anatomy and physiology, preventative screening, etc. Scan records as required.
- Develop and maintain an effective, professional working relationship with providers and their staff
- Support providers in closing treatment opportunities (HEDIS/Star measures)
- Assist leaders in monitoring issues, projects, timelines, and plans related to various corporate initiatives impacting providers
- Research, analyze, identify, and evaluate data to assess existing trends and issues
- Recommend, communicate, and implement solutions to identified problems and root cause of issues
- Represent and participate in group discussions
- Assist other departments / consultants when visiting providers to discuss a variety of HEDIS/Star related topics
- Generate summary of activity monthly and as requested
Requirements:
- Current unrestricted state of Michigan registered nurse license required
- Knowledge of quality improvement / process improvement / clinical guidelines
- Experience with MS Office skills. Excel is a plus
- Minimum three years of clinical experience
- Knowledgeable of NCQA HEDIS medical record review
- Bachelor’s degree in nursing
- Strong knowledge and experience in use of software (e.g., Excel, Outlook, PowerPoint, Word, etc.).
- Effective communication skills, written and verbal
- Experience in provider consulting/relations
- Strong analytical, organizational, planning, and problem-solving skills
- Ability to effectively interface with employees at all levels
- Ability to understand and apply statistical inference including research principles
- Demonstrated medical and clinical knowledge required to analyze related issues and apply principles to health care business environment.
- R.N. licensed in Michigan; BSN degree preferred. Associate degree acceptable with professional experience
Why Should You Apply?
- Health Benefits
- Referral Program
- Excellent growth and advancement opportunities
As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.
About the Company
I
Iconma
ICONMA is a global information consulting management firm providing Professional Staffing Services and Project-Based Solutions for organizations in a broad range of industries.
- Corporate Headquarters in Troy, Michigan; 20+ locations worldwide.
- Certified Woman-Owned Business Enterprise (WBE); certified by Women’s Business Enterprise National Council, National Women Business Owners Corporation (NWBOC); and California Public Utilities Commission (CPUC).
- Founded in 2000
- 2000+ Employees
The company was founded on the principle that success is derived from delivering high quality service and resources in the most responsive, flexible, and innovative way. ICONMA invests in people and resources with a single goal: To provide our customers with the highest quality service in the most responsive manner. Through its network of offices, ICONMA provides the resources to help clients maintain their competitive advantage.
COMPANY SIZE
2,000 to 2,499 employeesINDUSTRY
Management Consulting Services
EMPLOYEE BENEFITS
401K, Employee Referral Program, Life Insurance
FOUNDED
2000
WEBSITE
https://www.iconma.com/