Coordinator Quality Management RN - TRN (Fresno, CA)
Company Description THE RECRUITING NETWORK (TRN) Job Description The Coordinator Quality Management RN -
Responsibilities:
2.
Analyze data and prepare concise, accurate and meaningful quality management reports in accordance with QM principles.
3.
Actively collaborate with Plan and/or Corporate teams to improve sustainable member outcomes.
4.
Coordinate plan level resolution of member complaints/grievances in assigned population.
6.
Assist in the preparation of information for RFIs, RFPS, and other QM related meetings and initiatives.
9.
Complete all other duties as assigned.
Qualifications:
EDUCATION AND EXPERIENCE Education Required:
o Associate's degree in nursing or related field.
Preferred:
o Bachelor's degree (or equivalent) in nursing or related field.
Years and Type of Experience Required:
o 2 years experience in quality improvement, risk management and/or utilization review in a managed care setting.
Preferred:
o Knowledge of local and national quality management and regulatory standards, including NCQA and HEDIS reporting.
Certifications or Licensures Required:
o Current professional RN license.
Preferred:
o CPHQ Language Skills Required:
o English Preferred:
o Bilingual capabilities (Spanish or other) Technical Capabilities o Proficiency in company supported software (i.
e.
, Excel, Outlook, Word) Behavioral Competencies o Good verbal and interpersonal skills.
o Good telephonic skills.
o Professional demeanor.
o Appreciation of cultural diversity and sensitivity toward populations served.
o Organizational skills and ability to multi-task.
Base Salary - $75,000 - $87,000 Source:
.
Estimated Salary: $20 to $28 per hour based on qualifications.
Responsibilities:
2.
Analyze data and prepare concise, accurate and meaningful quality management reports in accordance with QM principles.
3.
Actively collaborate with Plan and/or Corporate teams to improve sustainable member outcomes.
4.
Coordinate plan level resolution of member complaints/grievances in assigned population.
6.
Assist in the preparation of information for RFIs, RFPS, and other QM related meetings and initiatives.
9.
Complete all other duties as assigned.
Qualifications:
EDUCATION AND EXPERIENCE Education Required:
o Associate's degree in nursing or related field.
Preferred:
o Bachelor's degree (or equivalent) in nursing or related field.
Years and Type of Experience Required:
o 2 years experience in quality improvement, risk management and/or utilization review in a managed care setting.
Preferred:
o Knowledge of local and national quality management and regulatory standards, including NCQA and HEDIS reporting.
Certifications or Licensures Required:
o Current professional RN license.
Preferred:
o CPHQ Language Skills Required:
o English Preferred:
o Bilingual capabilities (Spanish or other) Technical Capabilities o Proficiency in company supported software (i.
e.
, Excel, Outlook, Word) Behavioral Competencies o Good verbal and interpersonal skills.
o Good telephonic skills.
o Professional demeanor.
o Appreciation of cultural diversity and sensitivity toward populations served.
o Organizational skills and ability to multi-task.
Base Salary - $75,000 - $87,000 Source:
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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