Clinical Quality Management Analyst – Registered Nurse

Role Overview

• Develop and manage process improvement initiatives for member and providers
• Conduct, collect and analyze information from office site and/or medical record reviews
• Monitor changes, corrections and clarifications in applicable regulatory/accrediting body requirements
• Conduct continuing education to providers on STARS, HEDIS, and HCC Coding

Requirements

• Current state RN or LPN license or Bachelor’s degree in a Healthcare-related field
• 3 years of nursing or healthcare-related field experience
• 6 years of experience with HEDIS/Quality abstraction, HCC Coding/medical coding, or healthcare related field in lieu of bachelor's degree

Benefits

• Health insurance
• Retirement plans
• Professional development opportunities
• Paid time off