RN - Quality and Provider Education

Strategic Staffing Solutions (S3) has an opening!

RN Quality and Provider Education (Contract)

Location:

Port Huron, MI area

Duration: 12+ months

Role Type: W2 Contract Engagement

This project involves provider visits to develop partnerships, provide training, education, and review of medical records and other requests that support a variety of corporate initiatives. Knowledge of NCQA HEDIS measures is preferred. The candidate must be licensed as a Registered Nurse in Michigan and have a dependable vehicle. In-state travel requirements vary throughout the year and could be up to five days a week at times.

• Provide comprehensive research and responses for identified problems and complex inquiries related to the provider community.
• Conduct activities such as in-home Bone Mineral Density (BMD) testing on members.
• Conduct in-state provider educational sessions in person on relevant topics such as new business tools, billing/coding, HEDIS, medical record reviews, etc.
• Perform clinical reviews with knowledge of clinical documentation, body systems, anatomy and physiology. 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.

• 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.

• Valid MI driver’s license; willing to drive to provider locations and travel throughout Michigan as needed (no exceptions).
• RN with HEDIS experience but will interview qualified RNs. RNs with professional coding experience is a plus.
• Dependable vehicle every workday and willing to travel up to five days a week and stay overnight when appropriate (overnights are rare but needed on occasion).
• Minimum three years of clinical experience.

• Registered Nurse licensed in Michigan; BSN degree preferred. Associate degree acceptable with professional experience.
• Beware of scams. S3 never asks for money during its onboarding process.

Mid‑Senior level

Full-time

Health Care Provider

Software Development