Nurse Quality Management
On-siteSeguin, Texas, United States
EXPIREDSeguin, Texas, United StatesOn-siteFull TimeBachelors DegreeLarge
Full TimeBachelors DegreeLarge
Job Summary
Coordinate with Community First Health Plans and various departments to ensure contractual, regulatory, and accreditation requirements, including NCQA and HEDIS, are met. Monitor performance on quality metrics against state and federal standards while managing data collection systems for accuracy. Provide oversight of member-level clinical care data and provider performance reviews, and lead process improvement efforts. Requires Texas RN licensure, five years of healthcare experience, and proficiency in data analysis and Microsoft Office.
Required Qualifications
- Graduation from an accredited school of professional nursing
- Bachelor's degree in nursing, clinical informatics, or other health care, or other health care related field
- Five or more years of relevant healthcare experience
- Current licensure as a Registered Nurse in the State of Texas
- Excellent communication and interpersonal skills
Desired Qualifications
- Experience in data analysis and preparation of quality improvement or related reports
- Experience with Microsoft Office (Outlook, Word, Excel)
- Quality Management certification such as CPHQ or CHCQM
- Working knowledge of continuous process improvement principles and standard coding products
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