The Bilingual HEDIS and Risk Adjustment Nurse Practitioner performs functions that are both clinical and administrative. The patient care responsibilities are primarily telephonic and the administrative is primarily reviewing records and charts.

The HEDIS and Risk Adjustment Nurse Practitioner must be a licensed and credentialed provider. This NP must have excellent clinical skills in order to analyze medical information, consider differential diagnoses and suggest diagnoses that are applicable to patients.

The HEDIS and Risk Adjustment NP is also detailed in obtaining and reviewing the applicable medical records and clinical criteria. This employee should behave in a professional manner when interfacing with Medical Directors, physicians, office staff and other internal and external customers.

Qualifications

1. Credentialed and Licensed Nurse Practitioner.

2. Bilingual (fluent in Spanish and English) is required. 

3. Minimum of five years experience in clinical setting as either Family Practice, Internal Medicine.

4. Familiarity with managed care, commercial and point of service medical care preferred.

5. Computer literate with knowledge and experience with specific software such as Word, Excel, Access.

About the Hospital

As one of the largest physician-led networks in Southern California, we have thousands of physicians and hundreds of hospitals committed to providing quality healthcare to all of the communities we serve.

Every day, our employees are inspired to make a difference in the lives of others as well as transform their own experiences to achieve a higher sense of fulfillment. Our employees become a part of an extraordinary team of people dedicated to health, wellness, and happiness for themselves and others. There is no greater reward than contributing to a positive work environment where compassion, understanding, care and attention are encouraged and valued.