LVN Quality Improvement Clinical Coordinator CCH

Community Health System•Fresno, CA

8d•$36 - $45

About The Position

The Clinical Coordinator, Quality Improvement supports quality management and improvement activities for Community Care Health (CCH), with primary accountability for Potential Quality Issue (PQI) oversight, medical record audits, and Population Health Management (PHM) clinical support as needed. Within LVN scope of practice, this role performs clinical and operational review, maintains quality documentation and tracking, supports provider and internal follow-up, prepares quality reports, and assists the QI Manager with regulatory, accreditation, committee, and audit-readiness activities. The role focuses on investigating member complaints, conducting history reviews, and interacting heavily with providers and internal departments. This position requires an individual to deliver internal training (annually), provider trainings (annually), and committee presentations (quarterly) to all levels of stakeholders.

Requirements

High School Diploma, High School Equivalency (HSE), or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required.
Completion of an accredited Vocational Nursing School program OR become licensed by equivalency required.
3 years of commercial health plan managed care, quality improvement, medical record review, or clinical documentation review related healthcare experience required.
High proficiency in Microsoft Excel (creating/managing spreadsheets) and PowerPoint (developing presentations).
High degree of organization, laser focus, ability to prioritize, and strong critical thinking.
LVN - Current and valid Licensed Vocational Nurse license to work within the state of California required.

Nice To Haves

Associate’s Degree in Nursing, Health Administration, Public Health, Healthcare Quality, or related field preferred.
Experience with PQI review, medical record audits, HEDIS, population health, provider follow-up, regulatory/accreditation support, or health plan quality operations preferred.
Experience maintaining detailed trackers, audit-ready documentation, workplans, and quality reports preferred.
Bilingual in Spanish is a strong preferred.
Clinical certification in area specialty preferred.
CPHRM - Certified Healthcare Risk Management preferred.
CPHQ - Certified Professional Healthcare Quality preferred.

Responsibilities

Supports quality management and improvement activities for Community Care Health (CCH).
Primary accountability for Potential Quality Issue (PQI) oversight, medical record audits, and Population Health Management (PHM) clinical support as needed.
Performs clinical and operational review within LVN scope of practice.
Maintains quality documentation and tracking.
Supports provider and internal follow-up.
Prepares quality reports.
Assists the QI Manager with regulatory, accreditation, committee, and audit-readiness activities.
Investigates member complaints.
Conducts history reviews.
Interacts heavily with providers and internal departments.
Delivers internal training (annually).
Delivers provider trainings (annually).
Delivers committee presentations (quarterly) to all levels of stakeholders.