Highmark Health
Clinical Quality Management Analyst - Registered Nurse (Remote)
7 days agoWhat's your preference?
Job Description
- Req#: J276626
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $91,200.00
- Opportunity for career advancement and growth within the organization
- Engaging work environment with a focus on quality improvement and compliance
- Chance to impact member care and provider satisfaction positively
- Supportive of continuous education and professional development
- Work in a dynamic office-based setting with occasional site visits
What to Expect (Job Responsibilities):
- Develop and manage process improvement initiatives to enhance member and provider experiences
- Conduct thorough reviews and analyses of medical records to ensure proper documentation and coding
- Monitor and adjust compliance plans in accordance with regulatory requirements
- Perform retrospective and prospective audits, providing feedback to providers on performance
- Collaborate with various departments to facilitate quality improvement programs and initiatives
What is Required (Qualifications):
- Current state RN or LPN license or Bachelor’s degree in a healthcare-related field
- Minimum of 3 years of experience in nursing or a healthcare-related field
- Current State of PA RN or LPN licensure or current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC)
- CPC, CRC, RHIA, RHIT, or CCS Certification or ability to obtain within 4 months of hire
- Strong analytical and problem-solving skills, with the ability to interpret clinical data
How to Stand Out (Preferred Qualifications):
- 1 year of project management experience
#HealthcareServices #QualityImprovement #CareerOpportunity #CompetitivePay #NursingJobs
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