Disease Management Outreach and HEDIS Specialist- Supports disease management program by coordinating efforts pertaining to disease management for members and providers within the system. Implements multiple aspects of the disease management program including member outreach, provider education, community partnerships, documentation of contacts and creation of reports. Also assists with documentation to support National Committee for Quality Assurance (NCQA), URAC or general accreditation and HEDIS efforts as they relate to disease management.
MINIMUM QUALIFICATION:
Education, Knowledge, Skills and Abilities
Degree in nursing required. Required professional skills include data entry into and retrieval from a managed care information system, and ability to effectively interface with physicians.
Required Length and Type of Experience
Minimum of one year experience in a managed care setting, preferably within a HMO, and a minimum of five years medical nursing, surgical nursing and/or nursing in the acute care setting.
Required Licensure or Certification
Current State of Iowa nursing license. Certification in Case Management (CCM) Preferred
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