Quality Improvement Coordinator, HEDIS, Virginia Premier

Location
Virginia Beach, VA
Salary
Competitive
Posted
Aug 27, 2020
Closes
Oct 07, 2020
Ref
137780BR
Function
Other
Industry
Healthcare
Hours
Full Time
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

Other
Knowledge and understanding of regulatory and accreditation processes required

Keywords: Medical Record Review, HEDIS, Quality, "Quality Improvement", Richmond, Chesapeake, Health Plans, Insurance, Registered Nurse, RN

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