MI Licensed RN Quality and Provider Education/HEDIS measures or coding exp Job at Kyyba Inc., Grand Rapids, MI

SlM1NnhZczBRVFJXek1xdEdjUmFIVXZzK1E9PQ==
  • Kyyba Inc.
  • Grand Rapids, MI

Job Description

MI Licensed RN Quality and Provider Education/HEDIS measures or coding exp
long term 37.00 AN HOUR W2 contract + 5 PTO days
End Date: 10/31/2025
Position Type: Full Time/Contract
Location: Grand Rapids, MI, United States
Onsite Flexibility: 50% Remote

Location: Offsite / remote worker the majority of the time. Will need to be able to go into the Grand Rapids Steketee's building on occasion (need varies throughout year). Will need badge on start date.

While the position mostly includes remote work and traveling, the resource will be required to work onsite at a client location occasionally. This project will involve participating in provider visits to develop partnerships, provide training, education, and review of medical records as well as other requests that support a variety of corporate initiatives. Knowledge of NCQA HEDIS measures is preferred but will interview qualified RNs. The candidate must be licensed as a Registered Nurse in the state of 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.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following (other duties may be assigned):

1) Provide comprehensive research and responses for identified problems and complex inquiries related to the provider community.
2) Conduct activities as assigned such as in-home Bone Mineral Density (BMD) testing on members.
3) Conduct in-state provider educational sessions in person on relevant topics such as new business tools, billing/coding, Health e-Blue (HeB), HEDIS, medical record reviews, etc.
4) Perform clinical reviews with knowledge of clinical documentation, body systems, anatomy and physiology. Scan records as required.
5) Develop and maintain an effective, professional working relationship with providers and their staff.
6) Support providers in closing treatment opportunities (HEDIS/Star measures)
7) Assist leaders in monitoring issues, projects, timelines, and plans related to various corporate initiatives impacting providers
8) Research, analyze, identify, and evaluate data to assess existing trends and issues.
9) Recommend, communicate, and implement solutions to identified problems and root cause of issues.
10) Represent and participate in group discussions.
11) Assist other departments / consultants when visiting providers to discuss a variety of HEDIS/Star related topics
12) Generate summary of activity monthly and as requested

Qualifications:
To perform this job successfully, an individual must be able to effectively execute each essential duty. Contractors will be expected to attend annual training on HEDIS measures at the beginning of each year, and must pass according to predetermined testing requirements. The requirements listed below are representative of the knowledge, skill, and/or ability required throughout the year, although others may be needed.

Education / Certifications:
R.N. licensed in Michigan; BSN degree preferred. Associate degree acceptable with professional experience.
Employment Type: Contractor
Salary: $ 37.00 Per Hour

Job Tags

Hourly pay, Full time, Contract work, For contractors, Remote work,

Similar Jobs

Wellington International

Social Media Manager Job at Wellington International

 ...Job Summary: The Social Media Manager is a self-motivated, creative thinker with experience...  ...company's brand social media accounts on Facebook, Twitter, TikTok, YouTube, Instagram, and...  .... Proficient in pixel management and ad manager platforms. A strong working... 

Book of the Month

Editorial Assistant Rotational Program Job at Book of the Month

 ...maintaining & expanding contact databases, developing presentations for publishers, and communicating efficiently and professionally with industry...  ..., with the ability to interface comfortably with people at all levels Great judgment, with the ability to handle sensitive... 

DHL Express

Account Executive (P2) DHL Express - Chicago, IL (DHL Express) Job at DHL Express

 ...What makes DHL great? Our People! We know each employees individual contributions make us the #1 Delivery and Logistics Company in the world. Distinguished as No. 1 Worlds Best Workplace by Great Place to Work and Fortune Magazine DHL is committed to maintaining... 

General Dynamics Information Technology

Cyber Security Analyst - FBI ECS Division Job at General Dynamics Information Technology

 ...Type of Requisition:** Regular**Clearance Level Must Be Able to Obtain:** Top Secret/SCI...  .../Other Required:** None**Job Family:** Cyber Security**Skills:**Cyber Defense,Incident...  ...ensuring seamless collaboration among security analysts, threat intelligence teams, streamlined... 

TEKsystems

Transport Engineer - Nokia Job at TEKsystems

TEKsystems is seeking a Telecom Transport Network Engineer with strong Nokia experience for a Long Term OpportunityThis role can sit remotely in the US. Candidates MUST be eligible to work in the US for any employer WITHOUT sponsorship.This is a W2 contract to hire opportunity...