QUALITY IMPROVEMENT COORD

Location
Virginia Beach, VA
Posted
May 15, 2017
Closes
Jul 25, 2017
Function
IT, QA Engineer
Industry
Healthcare, Other
Hours
Full Time
Job Description:
***COME JOIN US AS WE EXPAND OUR SERVICES***
Optima is seeking an experienced RN with a QI (quality improvement) experience to assist with chart reviews and provide regulatory knowledge and Medicaid expertise in support of our expansion of member services in the state of Alabama. This position requires reporting onsite to our QI department located in our Virginia Beach, VA corporate office (no tele-commute option). The ideal candidate will assist with data analysis and contribute to the development of performance improvement projects to support this exciting new Alabama Community Care division. Light travel is required to include possible overnight travel to Alabama in support of these programs initiatives and other analytical responsibilities.

The Quality Improvement Coordinator is responsible for coordinating the design, development, implementation, and evaluation of the heath plan's clinical quality functions. Assists in developing focused and/or specialized studies based on high volume, high risk, high cost, and/or problem prone areas, and periodically monitors and evaluates related performance goals. Collaborates with Clinical Care Services to improve health status for chronic diseases based on demographic and epidemiological characteristics of the membership.Assists in maintaining accreditation and certifications for NCQA and MCHIPS, as well as assisting to meet the requirements for state and federal (DMAS and CMS) regulations and requirement.

Education Level
RN-Bachelor's Level Degree

Experience
Required: Clinical - 3 years, Quality Improvement - 3 years

Preferred: None, unless noted in the “Other” section below

License
Required: Registered Nurse

Preferred: None, unless noted in the “Other” section below

Skills
Required:

Preferred: None, unless noted in the “Other” section below

Other
Knowledge and understanding of regulatory and accreditation processes required