Health Plan Quality Improvement Coordinator

Job description

City/State Virginia Beach, VA Work Shift: First (Days) Overview: Sentara Health Plans in Virginia Beach is looking to hire a Remote Health Plan Quality Improvement Coordinator. This is a remote position; however, candidates must reside in Virginia North Carolina or Florida. The Quality Improvement Coordinator is responsible for coordinating the design, development, implementation, and evaluation of the heath plan's clinical quality functions. Assists in developing focused and/or specialized studies based on high volume, high risk, high cost, and/or problem prone areas, and periodically monitors and evaluates related performance goals. Collaborates with Clinical Care Services to improve health status for chronic diseases based on demographic and epidemiological characteristics of the membership. Assists in maintaining accreditation and certifications for NCQA and MCHIP, as well as assisting to meet the requirements for state and federal (DMAS and CMS) regulations and requirement. Certification: - BSN preferred - Associate’s degree (Required) or - LPN Diploma may be accepted in lieu of associate’s degree - Registered Nurse preferred. Experience: Keywords: Talroo-Allied Health, Qualit...