I ntegrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
Job Description Clinical Nursing staff must have an active Florida license. Recent experience in data collection for HEDIS / Stars preferred. Determine member compliance according to the NCQA technical specifications. Computer skills are critical. Excellent verbal and phone skills are required. Communicate with provider, internal customers and external vendors. Organizational skills are very important ; must be able to work independently to complete tasks with minimal direction. Position will include some administrative tasks to including but not limited to; faxing, and populating spreadsheets.
Required to track, monitor and report on the status of records and volume of work.
Requirements:
Active Florida Nursing License
Previous medical record review experience; HEDIS preferred
Medical Review Nurses: Quality review / disease management experience
AAAHC, Joint Commission, or Magnet experience is helpful
Proficient in Microsoft Word and Excel
Excellent communication skills
Successful completion of Excel test
Additional Information All your information will be kept confidential according to EEO guidelines.