Quality Nurse Specialist - HEDIS, NCQA
Posted 2025-09-08
Remote, USA
Full Time
Immediate Start
Position at a Glance:Location: RemotePosition: Quality Nurse Specialist - HEDIS, NCQAStart Date: Immediate openings availableCompensation: a competitive salaryCompany: Pathremotenetwfh
Description:
• The Quality Nurse Specialist will be an integral member of the Peak Healths quality team.
• This position is responsible for overseeing performance improvement activities, ensuring regulatory compliance, and other initiatives that lead to effective clinical resource utilization and improvements in quality.
• These duties may include but are not limited to HEDIS/Stars oversight, committee support, performance monitoring and assessment, data collection and analysis, and the continual advancement of the quality improvement process to achieve Peak Healths goals of excellence.
Requirements:
• Current unencumbered licensure with the WV Board of Registered Nurse Professional Nurses, or appropriate state board where services will be provided, as a Registered Nurse professional OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC)
• Five (5) years of healthcare clinical experience
• Knowledge of CMS guidelines, regulations, NCQA® and HEDIS®
• Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN) or Diploma; Currently enrolled in a BSN program and BSN completion within three (3) years of hire
• Managed Care knowledge or experience
• 2-3 years Quality Management, Quality Improvement or Process Improvement Experience
Benefits: Apply Job!
Your Future Starts HereDon't miss out on this exciting role. We are looking forward to hearing from you. Apply now!
Description:
• The Quality Nurse Specialist will be an integral member of the Peak Healths quality team.
• This position is responsible for overseeing performance improvement activities, ensuring regulatory compliance, and other initiatives that lead to effective clinical resource utilization and improvements in quality.
• These duties may include but are not limited to HEDIS/Stars oversight, committee support, performance monitoring and assessment, data collection and analysis, and the continual advancement of the quality improvement process to achieve Peak Healths goals of excellence.
Requirements:
• Current unencumbered licensure with the WV Board of Registered Nurse Professional Nurses, or appropriate state board where services will be provided, as a Registered Nurse professional OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC)
• Five (5) years of healthcare clinical experience
• Knowledge of CMS guidelines, regulations, NCQA® and HEDIS®
• Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN) or Diploma; Currently enrolled in a BSN program and BSN completion within three (3) years of hire
• Managed Care knowledge or experience
• 2-3 years Quality Management, Quality Improvement or Process Improvement Experience
Benefits: Apply Job!
Your Future Starts HereDon't miss out on this exciting role. We are looking forward to hearing from you. Apply now!