Nurse Consultant, Quality Management
Description:
• Ensures the delivery of evidence-based care and services for members according to HFS quality strategy and ABHIL population health model
• Directs analysis and reporting of member and provider data to monitor interventions and effectiveness
• Plans, conducts and evaluates targeted member/provider initiatives and supports development of HEDIS interventions and initiatives within the Quality Management Team
• Reviews documentation and interprets data from clinical records or systems to apply appropriate clinical criteria and policies in line with HEDIS, regulatory, and accreditation requirements
• Works closely with the Quality team, leadership and POSC to drive population-based improvements in care and outcomes
Requirements:
• 5 years experience in managed care, clinical, or health care related field
• 1 year of project management experience
• Registered Nurse (RN) license in the state of their residence
• Bachelors Degree required
Benefits:
• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
Apply Now
Apply Now
• Ensures the delivery of evidence-based care and services for members according to HFS quality strategy and ABHIL population health model
• Directs analysis and reporting of member and provider data to monitor interventions and effectiveness
• Plans, conducts and evaluates targeted member/provider initiatives and supports development of HEDIS interventions and initiatives within the Quality Management Team
• Reviews documentation and interprets data from clinical records or systems to apply appropriate clinical criteria and policies in line with HEDIS, regulatory, and accreditation requirements
• Works closely with the Quality team, leadership and POSC to drive population-based improvements in care and outcomes
Requirements:
• 5 years experience in managed care, clinical, or health care related field
• 1 year of project management experience
• Registered Nurse (RN) license in the state of their residence
• Bachelors Degree required
Benefits:
• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
Apply Now
Apply Now