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Job Details

Clinical Quality Management Nurse, HEDIS

Requisition #: 181008
Location: Johns Hopkins Health Care, Johns Hopkins Health Care, Ocean City, MD 21842
Category: Nursing
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: Yes
Date Posted: May 23, 2019

Johns Hopkins Health System employs more than 20,000 people annually. Upon joining Johns Hopkins Health System, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field.

This is a telecommuting position based on the Eastern Shore.

The Clinical Quality Management Nurse reports to the Manager, Quality Improvement and assists in the development, implementation, and maintenance of a global Quality Improvement and Utilization Management Program for Johns Hopkins Health Care (JHHC). Assists with data collection of quality indicators to aggregate, trend, analyze and report results appropriate. Acts as liaison to JHHC and external customers. Assists with the coordination and management of the HEDIS Medical record review process to include but not limited to; hiring and management of temporary nursing staff, management and authorizing the time of these staff, productivity and quality of data abstraction. This person will be responsible for annual training and assessment of the clinical data abstractors for the HEDIS project. This person will also be involved in the tracking and coordination of global organizational improvement initiatives as directed by the QI committees. Supports the audit process to ensure compliance with the annual HEDIS Audit. Assist with other Quality improvement functions as needed within the department.

Requirements:

  • Completion of an approved course of study in Nursing; BSN preferred
  • Current RN licensure in the State of Maryland
  • Work requires a minimum of 2 years’ experience in managed care, a provider setting, or health care regulatory agency environment with a minimum of two years of experience in the area of utilization management or quality improvement. Direct experience with HEDIS preferred.
  • Must exhibit knowledge of medical records and analysis of processes of clinical care in addition to exhibiting knowledge of familiarity with the accreditation standards and principle
  • Strong analytical skills and statistical aptitude
  • Excellent verbal, written and listening communication skills and the ability to be detail-oriented and well organized

Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.

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