Title: RN - Field Nurse - Quality and Provider Education
Location: Grand Rapids, MI (mostly remote/local travel - please see notes below)
Role Type: W2 Contract Engagement
Duration: 12+ Months
Pay Rate: $35-40/hour plus travel reimbursement
**While the position mostly includes remote work and traveling, the consultant will be required to work onsite at Grand Rapids location occasionally.
Engagement Description
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
* Provide comprehensive research and responses for identified problems and complex inquiries related to the provider community.
* Conduct activities as assigned such as in-home Bone Mineral Density (BMD) testing on members.
* Conduct in-state provider educational sessions in person on relevant topics such as new business tools, billing/coding, HEDIS, medical record reviews, etc.
* Perform clinical reviews with knowledge of clinical documentation, body systems, anatomy and physiology. Scan records as required.
* Develop and maintain an effective, professional working relationship with providers and their staff.
* Support providers in closing treatment opportunities (HEDIS/Star measures)
* Assist leaders in monitoring issues, projects, timelines, and plans related to various corporate initiatives impacting providers.
* Research, analyze, identify, and evaluate data to assess existing trends and issues.
* Recommend, communicate, and implement solutions to identified problems and root cause of issues.
* Represent and participate in group discussions.
* Assist other departments / consultants when visiting providers to discuss a variety of HEDIS/Star related topics
* Generate summary of activity monthly and as requested.
Top 3 Required Skills/Experience:
1) Current unrestricted state of Michigan registered nurse license required
2) Knowledge of quality improvement / process improvement / clinical guidelines
3) Experience with MS Office skills. Excel is a plus
Required Skills/Experience:
* Valid MI driver's license; willing to drive to provider locations and travel throughout Michigan as needed (no exceptions)
* RN with HEDIS experience but will interview qualified RNs. RNs with professional coding experience is a plus.
* Have a dependable vehicle every workday and be willing to travel up to five days a week and stay overnight when appropriate
* Minimum three years of clinical experience
Education/Certifications
* R.N. licensed in Michigan; BSN degree preferred. Associate degree acceptable with professional experience.
