Quality Program Nurse, RN (Remote)

Inland Empire Health Plan
Any Location, CA
Remote
Job Description
IEHP is seeking a Quality Program Nurse, RN (QPN) to implement Quality Management policies, procedures, and activities, ensuring compliance with Regulatory Requirements (DHCS). The role involves data abstraction, CAP monitoring, and collaboration with providers to improve facility performance and support HEDIS/CAHPS goals. The position offers opportunities for professional development and contributes to a healthy work-life balance.

Requirements

  • Perform initial, periodic, and verification Site Review and Medical Record Surveys for assigned Primary Care Providers.
  • Review Primary Care Provider Corrective Action Plans (CAP) submissions and monitor CAP compliance.
  • Work collaboratively with assigned Primary Care Providers to help remediate areas of non-compliance.
  • Perform annual HEDIS data abstractions.
  • Monitor assigned PCPs for potential problem hours and document findings.
  • Perform annual HEDIS data abstractions.
  • Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Benefits

  • Competitive salary
  • Telecommute schedule
  • CalPERS retirement
  • State of the art fitness center
  • Medical Insurance with Dental and Vision
  • Life, short-term, and long-term disability options
  • Career advancement opportunities
  • Wellness programs
  • Flexible Spending Account – Health Care/Childcare
  • CalPERS retirement
  • 457(b) option
  • Paid life insurance
  • Pet care insurance
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