Quality Improvement Spec Job
Coventry Health Care - St. Louis, MO

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Job Title: Quality Improvement Spec

Posting Location: MO - St. Louis (Maryville Centre)

Location: MO - St. Louis (Maryville Centre)

Employment Status: On Call

Job Requisition Number: 167254

External Description:
Quality Improvement Coordinator


Responsible for the research and identification of quality of care issues to
ensure compliance with Coventry's quality improvement programs as well as
accreditation and regulatory standards.


  • Maintains accurate documentation of all quality improvement activities, i.e.,
studies, surveys, audits, peer reviews, etc. Performs analysis and provides
oversight for delegated functions. Prepares weekly and monthly reports as
  • Performs quality improvement studies as they relate to trends identified via
utilization review activities, utilization patterns, audits, HEDIS results,
appeals, etc.
  • Identifies possible quality of care issues through research and data analysis.
Prepares and distributes accurate and timely reports according to department,
documentation standards, and regulatory requirements.
  • Under the direction of assigned Medical Directors and quality improvement
management, conducts audits to research quality of care issues .
  • Assists in conducting peer review chart audits, compiling statistics, and
reporting results to the peer review and quality improvement committees of the
assigned plan.
  • Monitors and assures that follow-up re-evaluation activities take place when
deficiencies are identified and recommendations for corrective action have been
  • Provides education to members and employer groups regarding preventive health
and wellness.
  • May complete an annual review of department policies and procedures and make
recommendations for updates based on changing needs or trends.
  • Assists in preparing the annual program evaluation and work plan.
  • Performs other duties as required.

  • Licensed Practical Nurse (LPN) or Registered Nurse (RN) with active state
license required.
  • Complies with all state certification requirements in the state where job
duties are performed.
  • Previous (2-4 years) clinical experience required.
  • Bachelor's degree preferred.
  • Previous quality improvement and/or managed health care experience preferred.
  • Fundamental knowledge of relevant legal, medical, and regulatory terms,
issues, and practices.
  • Good communication, organizational, analytical and computer skills.
  • Valid driver's license.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we
are committed to building a talented and diverse team.

Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we
are committed to building a talented and diverse team.

Coventry Health Care - 2 years ago - save job - copy to clipboard
About this company
358 reviews
In May of 2013, Coventry became a part of Aetna. We are excited to join together with common values and a common mission: empowering people...