+ This project will involve participating in provider visits to develop partnerships, provide training, education, and review of medical records as well as other requests that support a variety of corporate initiatives. + Provide comprehensive research and responses for identified problems and complex inquiries related to the provider community. + Conduct activities as assigned such as in-home Bone Mineral Density (BMD) testing on members. + Conduct in-state provider educational sessions in person on relevant topics such as new business tools, billing/coding, Health e-Blue (HeB), HEDIS, medical record reviews, etc. + Perform clinical reviews with knowledge of clinical documentation, body systems, anatomy and physiology. Scan records as required. + Develop and maintain an effective, professional working relationship with providers and their staff. + Support providers in closing treatment opportunities (HEDIS/Star measures) + Assist leaders in monitoring issues, projects, timelines, and plans related to various corporate initiatives impacting providers. + Research, analyze, identify, and evaluate data to assess existing trends and issues. + Recommend, communicate, and implement solutions to identified problems and root cause of issues. + Represent and participate in group discussions. + Assist other departments / consultants when visiting providers to discuss a variety of HEDIS/Star related topics. + Generate summary of activity monthly and as requested. Requirements + Current unrestricted state of Michigan registered nurse license required. + Knowledge of quality improvement / process improvement / clinical guidelines. + Experience with MS Office skills. Excel is a plus. + Valid MI driver’s license: willing to drive to provider locations and travel throughout Michigan as needed (no exceptions). + RN with HEDIS experience but will interview qualified RNs. RNs with professional coding experience is a plus. + Have a dependable vehicle every workday and be willing to travel up to five days a week and stay overnight when appropriate. + Minimum three years of clinical experience. + Associate degree acceptable with professional experience. Preferred Skills/Experience: + R.N. licensed in Michigan; BSN degree preferred. + Bachelor’s degree in nursing. + Strong knowledge and experience in use of software (e.g., Excel, Outlook, PowerPoint, Word, etc.). + Knowledge of NCQA HEDIS measures. + Medical chart review experience. + Effective communication skills, written and verbal. + Five years of experience in provider consulting/relations. + Strong analytical, organizational, planning, and problem-solving skills. + Ability to effectively interface with employees at all levels. + Ability to understand and apply statistical inference including research principles. + Demonstrated medical and clinical knowledge required to analyze related issues and apply principles to health care business environment. As an equal opportunity employer, ICONMA prides itself on creating an employment environment that supports and encourages the abilities of all persons regardless of race, color, gender, age, sexual orientation, citizenship, or disability.