Clinical Quality Nurse
On-siteSpringfield, Illinois, United States
Springfield, Illinois, United StatesOn-siteFull TimeHealthcare TechMedium
Full TimeMediumHealthcare Tech
Job Summary
Review quality measures and conduct clinical care reviews using criteria from programs like HEDIS and CMS. Partner with providers and nursing staff to implement actions that close care gaps, validate quality metrics, and develop interventions for performance improvement. Collaborate with internal departments to optimize workflows and reduce administrative burdens while maintaining relationships with payers to stay current on incentive programs. Travel to assigned clinic sites to support leadership and ensure compliance with incident reporting, OSHA, and clinic policies.
Required Qualifications
- RN or LPN with license in good standing in the State of Illinois
- CPR certification per American Heart Association guidelines
- Minimum of five (5) years experience in a health care setting
- Medical office preferred
- Familiarity with EHR clinical products
- Experience with the implementation of clinical software
- Experience in medical record review
- Experience in statistical data extrapolation
- Ability to travel to multiple Clinic locations
- Expertise in Microsoft Office products (Word, Excel, Access, Outlook)
- Ability to meet deadlines and work under pressure while providing a positive image
- Ability to work independently in all levels of the organization
- Ability to learn applicable skills and adapt easily to changes in processes or workflow
- Excellent organizational, verbal and written communication skills
- Strong leadership and motivational skills
- Strong background in business and integrated health care delivery
- HIPAA
Desired Qualifications
- Healthcare management or leadership experience
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