Responsibilities include facilitation of health plan continuous monitoring and improvement efforts. Activities include facilitation of ongoing studies, data collection (HEDIS, other NCQA requirements), analysis and reporting of results throughout organization.
Bachelor’s degree in a healthcare field, nursing (preferred) ; Master’s degree preferred
2 years experience in continuous quality improvement in a managed care environment
Computer skills in Microsoft Office, Visio, and Access.
Knowledge of HEDIS and NCQA Standards for Accreditation of Health Plans.
Knowledge of CPT/HCPCS/ICD-9-CM coding.
Clinical experience a plus
Active Nursing license preferred
Professional Services Network, Inc - 10 months ago