QI COORD - UM CONTRACT REPORT

Location
Norfolk, VA
Salary
Competitive
Posted
Nov 29, 2018
Closes
Dec 25, 2018
Ref
118205BR
Function
Nurse
Industry
Healthcare
Hours
Full Time
Overview:

Optima Health Community Care is hiring a QI Coordinator. This position is full time, day shift. BSN with knowledge and understanding of regulatory and accreditation processes required. Three years experience required.

Optima Health Community Care is a Commonwealth Coordinated Care Plus (CCC Plus) Medicaid plan for many older people and those with disabilities. CCC Plus is a Medicaid managed care program through the Virginia Department of Medical Assistance Services (DMAS).

With Optima Health Community Care, members benefit from an individualized, fully-integrated program with a state-wide network of providers. As an Optima Health Community employee, you will join a care team committed to providing customized and personalized support and services in the community that our members can count on. Optima Health is a service of Sentara Healthcare, so joining Optima is joining the Sentara Healthcare family.

Sentara Benefits:

Sentara employees strive to make our communities healthier places to live. We’re setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For more information about our employee benefits, CLICK HERE!

Join our team, where we are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, growth!

Other
Knowledge and understanding of regulatory and accreditation processes required

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.

Qualifications:

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

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