HCI 5-Star/HEDIS Outreach Nurse

Part-Time

About SCAN

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, and Nevada. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 40 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn, Facebook, and Twitter.

The job

Provide support to the Health Care Informatics 5 Star/HEDIS team by calling select members regarding specific clinical screenings needed to improve overall 5 Star/HEDIS scores.

You will

• Utilize knowledge of NCQA HEDIS Technical Specifications to measure compliance and to effectively communicate with members.
• Perform complete and accurate data entry to document communication with members and enters results into 5-Star/HEDIS electronic database software.
• Maintain integrity of private health information and operational activities, ensuring information is kept within the confines of the 5-Star/HEDIS team.
• Identify and communicate patterns of missing documentation for the assessment of additional records. This entails calling members as well as phoning and faxing medical offices to obtain further information.
• Route all complex issues to the Supervisor, HEDIS as necessary.
• Contributes to team effort by accomplishing related results as needed.
• Actively supports the achievement of SCAN’s Vision and Goals.

Your qualifications

• Required: G.E.D /High School
• 1 + years HEDIS and Medicare measures experience required
• Understanding of NCQA HEDIS Technical Specifications; Effective written communication and verbal skills, strong attention to details; Ability to multi-task and work within time constraints.

Covid-19 Vaccination Policy

To ensure a healthy and safe work environment, if you are selected for this position, your job offer with SCAN Health will be contingent upon being fully vaccinated and providing proof of your COVID-19 vaccine within 3 days after your start date. Generally, you are considered fully vaccinated 14 days after receiving the last dose, as recommended by the manufacturer, of a vaccine that has been authorized by the FDA for use in the United States, including vaccinations that have been approved pursuant to an Emergency Use Authorization. If fully vaccinated outside of the United States, the vaccination must be listed for emergency use by the World Health Organization (WHO). If you cannot receive the vaccine because of a disability/medical reason or sincerely-held religious belief, you may request an accommodation to this requirement by contacting COVID-19 Vaccination Policy. Learn more about the COVID-19 vaccination here - https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html

We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required. #LI-JR1

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)