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Registered Nurse Quality Assurance - Temporary RN
The Registered Nurse - Quality Assurance - Outreach's main function is to work with the HEDIS Manager to perform telephonic outreach in support of HEDIS and Stars work, with the possibility of cross training for HEDIS chart abstraction.
Estimated Hiring Range:
$102,330.00 - $125,070.00
Bonus Target:
Bonus - SIP Target, 5% Annual
Current CareOregon Employees: Please use the internal Workday site to submit an application for this job.
Essential Responsibilities

• Outreach to members in support of Stars measure gap closure and re-engagement.
• Use evidence-based approaches to patient education regarding engagement and recommended health screenings.
• Utilize a trauma-informed approach to provide member-centric support.
• Assist in helping members move through the continuum of care based on clinical/medical need.
• Make referrals to community partners as appropriate.
• Complete chart reviews for regulatory and quality improvement projects as assigned.
• Use various EMR systems, or PDF files to complete chart abstractions and enter data into a HEDIS specialized or other software.
• Maintain a 95% accuracy rate in abstractions and data entry, validated through peer over-reads.
• Communicate in a collaborative and professional manner with the CareOregon clinics, team members, and other CareOregon staff.
• Complete and successfully pass yearly and on-going HEDIS training and testing, as required, to maintain up-to-date knowledge of HEDIS and other quality improvement measurement requirements for performing chart abstractions.
• Participate in other projects, as assigned.

Organizational Responsibilities
Perform work in alignment with the organization's mission, vision and values.

• Support the organization's commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
• Strive to meet annual business goals in support of the organization's strategic goals.
• Adhere to the organization's policies, procedures and other relevant compliance needs.
• Perform other duties as needed.

Experience and/or Education
Required

• Current unrestricted license as a Registered Nurse in the State of Oregon

• Minimum 3 years' experience as an RN in the healthcare industry

Preferred

• Bachelor's degree in Nursing
• Knowledge or understanding of HEDIS and previous chart abstraction experience
• Prior primary care and/or specialty clinic practice experience
• RN experience with quality improvement, population health and/or case management

Knowledge, Skills and Abilities Required
Knowledge

• Knowledge of or desire to learn about current clinical practices specifically chronic diseases and guidelines for health screenings and health maintenance

Skills and Abilities

• Ability to utilize a trauma-informed approach to provide member-centric support.
• Ability to efficiently glean clinical information from a medical record, accurately document in the HEDIS or other specialized software, and save supporting documentation as instructed
• Eagerness to sometimes search for the data equivalent of a needle in the haystack and also ability to move on if it is not found
• Critical thinking skills
• Strong attention to detail
• Competency with computers and software programs, e.g. PDF, MS Outlook, Word, Excel, EMR systems
• Ability to learn and adapt to new EMR systems, software programs, specification changes and deadlines
• Ability to maintain strict confidentiality of protected health information
• Awareness of the social determinants of health impacting CareOregon members and approaching interactions with clinics, members or CareOregon embedded staff with kindness and friendliness
• Ability to work in an environment with diverse individuals and groups
• Have a high degree of initiative and motivation along with ability to effectively collaborate and plan with co-workers and others
• Ability to manage multiple tasks and flexibility to switch tasks as needed
• Act professionally at all times when representing CareOregon
• Ability to work under pressure and help the team meet deadlines for regulatory deliverables
• Good written and verbal communication skills
• Ability to prioritize work in a remote environment
• Ability to work effectively with diverse individuals and groups
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
• Ability to stand and sit for at least 3-6 hours/day
• Ability to speak clearly, bend, lift, carry, push, pull, and/or pinch small objects for at least 1-3 hours/day

Working Conditions
Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure
Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person
Hazards: May include, but not limited to, physical and ergonomic hazards.
Equipment: General office equipment and/or mobile technology
Travel: May include occasional required or optional travel outside of the workplace; the employee's personal vehicle, local transit or other means of transportation may be used.
Work Location: Work from home
We offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information.
We are an equal opportunity employer
CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.