Quality Improvement Coordinator II
$70,117–$126,194 year
RemoteWisconsin, United States
Job Summary
Conduct on-site quality reviews of delegated entities, physician offices, and clinics to resolve issues and generate written findings. Audit medical records, analyze administrative claims, and compile utilization reports for quality improvement studies. Document, investigate, and resolve formal complaints, risk management cases, and sentinel events related to care quality. Schedule and chair meetings with community agencies, develop corrective action plans, and recommend enhancements to quality policies. Serve as the primary liaison for clinical initiatives, including health fairs, and enforce contract terms regarding data submission.
Required Qualifications
- Bachelor's degree in Nursing preferred
- 3+ years of clinical, quality improvement or healthcare experience
- 2+ years of experience in quality function in a healthcare setting
Desired Qualifications
- LPN, LVN, RN, PA, or LCSW license preferred
- CPHQ (Certified Professional in Healthcare Quality) preferred
- Abstractions and Overread experience highly preferred
- MedSurge experience highly preferred
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