Clinical Nurse Auditor, HEDIS •Remote •
Providence Health Plan caregivers are not simply valued – they’re invaluable. and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.Providence Health Plan is calling a Clinical Nurse Auditor, HEDIS who will :• Be responsible for conducting clinical quality audits for the Quality Department• Identify and coordinate clinical audits to determine potential areas for quality improvement within the PHP network• Collect data by way of chart extraction, using objective specifications for the Healthcare Effectiveness and Data Information Set (HEDIS) program• Conduct Audits, which include review of outpatient medical records, hospital records, clinical lab and pharmacy records• Be responsible for collecting data based on standardized methodologies• Organize data to identify and address opportunities for improvement• Perform chart audits electronically or on site in physician practices during the audit season• Successfully complete HEDIS training prior to performing chart abstractions• Maintain all collected records in a confidential manner• Perform all duties in a manner which promotes team concept and reflects the Providence Health Plan's mission and philosophy• Communicate in a collaborative manner with the team in a way that represents Providence Health PlanPlease note the following important detail regarding this HEDIS Seasonal Role :• This posting is for multiple openings of a Nurse Auditor, HEDIS• This position is affiliated with Providence Health Plan and will be tied to a location and compensation range in Beaverton, Oregon• Position Type : Temporary, Per Diem, Non Benefitted• Length of Program Anticipated to last between : January 2026 - May 2026• Work Schedule : Monday - Friday• Work Hours Scheduled Weekly : 40• Additional Info : This position will require a full time commitment to the project, meaning no extended time off during the HEDIS Season (January 2026 - May 2026)• Positions specified as “on call / per diem” refer to employment consisting of shifts scheduled on an “as needed basis” to fill in for staff vacancies.Providence Health Plan welcomes remote work for applicants who reside in :• Washington• OregonRequired qualifications for this position include :• Degree in Nursing• Oregon Registered Nurse License• 5+ years clinical experience (Nursing)Preferred qualifications for this position include :• Bachelor's Degree in Nursing• Dual RN License : Oregon and Washington• 1 year Quality management / quality improvement / utilization review auditing experience, including experience in auditing within electronic health records.• Experience with health plans, project management, program evaluation, team facilitation, data analysis, and / or case review. Why Join Providence Health Plan? Our are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our of caring for everyone, especially the most vulnerable in our communities. Apply To this Job Apply To This Job