What you can expect!
Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!
Under the direction of the Manager, Quality Management Nurses, Quality Program Nurse (QPN), RN is responsible for the implementation of Quality Management policies, procedures, and activities. Quality Program Nurse, RN enforce DHCS regulatory requirements as pertaining to Facility Site Review (FSR) and Medical Record Review (MRR) criteria.
1. Perform initial, periodic, and verification Site Review and Medical Record Surveys for assigned Primary Care Providers. Conduct other regulatory audits as assigned.
2. Review Primary Care Provider Corrective Action Plans (CAP) submissions and monitor CAP compliance.
3. Perform focused audits as directed by IEHP Subcommittees.
4. Perform annual HEDIS data abstractions.
5. Monitor assigned PCPs for potential problem hours and document findings.
6. Review QM reports and CAP log on a weekly basis. Responsible for Provider compliance and follow up.
7. Attendance and participation in Quality Management Committee and/or Subcommittee meetings, as needed.
8. Attend Site Review and Medical Record Survey training, as mandated by DHCS, to maintain and become a Certified Site Reviewer.
9. Attendance and participation in Quality Management, Medical Services, and other inter-departmental staff meetings as indicated.
10. Attendance and participation in Quality Management Committee or Subcommittee meetings, as directed.
Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
Perks
IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.
Education & Experience
Key Qualifications
Start your journey towards a thriving future with IEHP and apply TODAY!
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