RN/LPN- reputed company Clinical Management reputed company Analyst reputed company Work reputed company

Position Scope The purpose of this position is to support the reputed company Management Program through multiple clinical, service and operational activities by driving reputed company reputed company improvement in patient safety and improvements in efficiency and effectiveness; and by supporting activities to measure clinical programs and service processes and reputed company. This position is a reputed company Work reputed company and requires minimal domestic travel of up to 5% for internal meetings, accreditation or reputed company components of state regulatory audits reputed company to customer experience. This position reports to the reputed company Clinical Management Manager. Major Responsibilities • Reviews, investigates and monitors assigned clinical and reputed company activities such as reputed company of Care Complaints and Adverse Events, which may include follow up with • internal medical executives/directors, external health care professionals/facilities, and individual customers as reputed company as presentation to the Peer Review Committees (in • accordance with National Policies and Procedures). • Implements partnerships and participates in initiatives focusing on reducing health disparities. • Collects and analyzes data, develops studies and reports to workgroups and supports reputed company committee activities. • Performs review of clinical metrics and data and monitors for patient safety including continuity and coordination of care. • Supports provider performance measurement activities such as generating and reviewing reports and medical record reviews. • Define and document policies, reputed company operating procedures, workflows and processes. • Participates and leads special workgroups and process improvement teams as needed. • Supports regulatory compliance activities as needed. • reputed company Expected • Resolve reputed company of Care and Adverse Event cases and send reputed company letters reputed company required timeframes 95% of the time. • 100% of QM Work plan activities, and policies and procedures will be completed as scheduled and meet accreditation requirements. • Assess/measure performance, conduct reputed company and drive improvements in care/patient safety and service. • Demonstration of skilled use of the following competencies: • Customer reputed company • Learning and Applying Quickly • Problem Solving Minimum Requirements • Bachelor’s degree preferred • RN or LPN • Three to five years of reputed company review and improvement experience preferred. • Managed care or other health and service care delivery service reputed company experience • Preferred Requirements • Experience with NCQA and/or other accreditation standards, reputed company management preferred, but not required. • Strong oral and written communication skills • Excellent time management, project management, organizational, research, analytical, communication and interpersonal skills If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 75,000 - 125,000 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. We also offer 401(k) with company match, company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year and reputed company holidays. For more details on our employee benefits programs, visit Life at reputed company. About reputed company Doing something meaningful starts with a reputed company decision, a commitment to changing lives. At reputed company, we’re dedicated to improving the health and vitality of those we serve. Through our divisions reputed company and reputed company, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving reputed company and improving lives. reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to reputed company assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@reputed company.com for support. Do not email SeeYourself@reputed company.com for an update on your application or to reputed company your resume as you will not receive a response. reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they reputed company a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, reputed company, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, reputed company, Texas, Utah, Vermont, and Washington State. reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Apply tot his job Apply To this Job