Quality Improvement Senior Clinical Registered Nurse
About The Position
Become a part of our caring community and help us put health first The Quality Improvement Senior Clinical Professional (RN) is responsible for the implementation and management oversight of the company's Medicare Stars Program in the Central FL/Orlando region. The Quality Improvement Senior Clinical Professional (RN) develops programs designed to increase the plan quality. Partners with leaders regarding implementation planning. Reviews and communicates results of programs. The Quality Improvement Clinical Professional (RN), also known as Senior Stars Improvement, Clinical Professional (RN), represents the scope of health plan/provider relationships. This scope spans across the following areas. The Quality Improvement Clinical Professional (RN) will report to the Manager, Stars Improvement, Clinical. Provider facing Zoom virtual/telephonic meetings Quality/clinical management and population health HEDIS and Stars performance Operational improvements Financial performance and incentive programs Data sharing and connectivity Documentation and coding Additional areas related to provider performance, member experience, market growth, provider experience and operational excellence
Requirements
- Licensed Registered Nurse (RN) without restriction in applicable state
- 5+ years of clinical nursing experience
- 1+ years' experience in a healthcare operational role, including hospital, provider or member facing nursing responsibilities
- Experience in provider engagement and relationship management
- Experience with Stars measures and quality improvement programs
- Proven ability to influence clinical practice or provider performance
- Comprehensive knowledge of Microsoft Office applications, Word and Excel with advanced knowledge of PowerPoint
- Valid driver's license with reliable transportation and the ability to travel up to 30% within the region
Nice To Haves
- Bachelor's degree in nursing
- 3+ years of managed care experience
- 3+ years of case management experience
- Knowledge of HEDIS/Stars/CMS
Benefits
- Health benefits effective day 1
- Paid time off, holidays, volunteer time and jury duty pay
- Recognition pay
- 401(k) retirement savings plan with employer match
- Tuition assistance
- Scholarships for eligible dependents
- Parental and caregiver leave
- Employee charity matching program
- Network Resource Groups (NRGs)
- Career development opportunities
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
