Health Plan Quality Improvement Coordinator
About The Position
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. 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.
Requirements
- BSN preferred
- Associate’s degree (Required) or LPN Diploma may be accepted in lieu of associate’s degree
- 3 years of quality improvement experience (Required)
- 3 years of regulatory and accreditation (Required)
Responsibilities
- Coordinating the design, development, implementation, and evaluation of the heath plan's clinical quality functions.
- 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.
- Collaborating with Clinical Care Services to improve health status for chronic diseases based on demographic and epidemiological characteristics of the membership.
- Assisting 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.
Benefits
- Medical, Dental, Vision plans
- Adoption, Fertility and Surrogacy Reimbursement up to $10,000
- Paid Time Off and Sick Leave
- Paid Parental & Family Caregiver Leave
- Emergency Backup Care
- Long-Term, Short-Term Disability, and Critical Illness plans
- Life Insurance
- 401k/403B with Employer Match
- Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
- Student Debt Pay Down – $10,000
- Reimbursement for certifications and free access to complete CEUs and professional development
- Pet Insurance
- Legal Resources Plan
- Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
