Quality Improvement Nurse - RN or LPN - Full-time / Part-time

Role: Quality Nurse

-- RN or LPN Assignment:

Transcend - a rapidly growing wholly owned subsidiary of Humana Location: Fort Myers, FL **This is an agile opportunity for candidates located in the

Fort Myers, FL and surrounding areas only ** We help doctors do what they do best while engaging patients

in their care At Transcend we recognize the need to simplify population

health management for the people who provide health care. We support physicians

and care teams, provider groups and integrated delivery systems with practical

onsite services and solutions that help practices shift from a health care

system built on treatment transactions to a value-based model built on better

outcomes for patients more engaged as partners in their own care. Role Description At Transcend Population Health Management LLC, we deliver

population health care and financial risk management, clinical-integration technology,

and physician engagement services to health care providers through a captive

Independent Physician Association model. Transcend leaders and market teams

work onsite at physician practices to provide operational and medical

management infrastructure support, patient outreach and medical records

management. We also offer customized, intuitive technology that makes the

administrative side of value-based care easier for physicians and their teams. As a Quality RN, you will work collaboratively with

providers to focus on chronic/complex care members as related to HEDIS and Risk

Adjustment measures to come up with solutions to improve member outcomes. The

Quality RN will focus on SeniorProduct plans to guide, recommend and develop

practice specific strategies designed to improve HEDIS scores and all aspects

of quality. Primary responsibilities include: Develop, facilitate, and/or secure opportunities

to positively impact Triple Aim (cost/quality/documentation) Ensure quality goals are aligned and executed

effectively Provide resources, educates and coaches provider

practices on Quality Improvement Assess and leverage provider technology to

promote prospective and retrospective medical record abstraction Oversees HEDIS reporting and trend to identify

opportunities for quality improvement Partners with cross-functional teams, including,

Sr. Product/health plan Quality

Management to encourage member participation in population health Drives STAR measures: Consumer Assessment of Healthcare Providers

and Systems (CAHPS), Health Outcome Surveys (HOS), Care Management Services

(CMS) and Healthcare Effectiveness Data Information Sets (HEDIS) Key Competencies Builds Trust: Consistently models and inspires

high levels of integrity, lives up to commitments, and takes responsibility for

the impact of one's actions. Accountability: Meets established expectations

and takes responsibility for achieving results; encourages others to do the

same. Customer Focus: Connects meaningfully with

customers to build emotional engagement and customer advocacy. Simplifies

complexity and integrates internal efforts to deliver an optimal customer

experience. Executes for Results: Effectively leverages

resources to create exceptional outcomes, embraces change, and constructively

resolves barriers and constraints. Role

Essentials Active

RN or LPN license in the state(s) in which the nurse is required to practice Clinical

Quality knowledge Ability

to be licensed in multiple states without restrictions Prior

clinical experience preferably in an acute care, skilled or rehabilitation

clinical setting Strong

communication skills Ability

to work independently under general instructions and with a team Valid

driver's license Ability

to travel throughout the Fort Myers, FL metro area on a daily basis Role

Desirables BSN

or Bachelor's degree in a related field H ealth

Plan or provider practice quality experience Experience

working with Core Measures, HEDIS, HOS and/or CAHPS surveys, JCAHO, NCQA ,CMS

or other regulatory guidelines Previous

Medicare and Medicaid experience Previous

experience in quality management, acute or ambulatory a plus Additional

Information Humana is an

organization with careers that change lives---including yours. As an innovator in

the fast-paced industry of healthcare, we offer our associates careers that

challenge, support and inspire them to use their passion for helping others and

to lead their best lives. Transcend's main office is located in Louisville,

Kentucky, with regional offices throughout the country. For more information,

please visit www.TranscendPHM.com.

If you're ready to

help people achieve lifelong well-being, and be a part of an organization that

is growing and poised to make an impact on the future of healthcare, Humana and

Transcend have the right opportunity for you.