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RN Quality Management Coordinator, Insurance Services - Fresno, United States - Community Health System - CA Careers
Description
Overview:All positions are in Fresno/Clovis CA.
Exciting Opportunities Await You:
If you want to delve deeper, feel free to reach out.Responsibilities:
The RN Quality Management Coordinator plays a pivotal role in overseeing clinical functions related to quality management and enhancement, placing significant emphasis on meeting the regulatory obligations of our governing bodies. This role involves providing guidance and support to the Quality Improvement Director in overseeing various tasks aimed at boosting cost efficiency, ensuring compliance with pertinent state and federal regulations, and enhancing the health outcomes of CCH members. By staying abreast of both internal and external quality standards and programs such as HEDIS, AMP, and NCQA, the incumbent bolsters the organization's quality initiatives.
Qualifications:
Education:
- High School Diploma, High School Equivalency (HSE), or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate is mandatory.
- A Bachelor's Degree in Nursing (BSN) is highly preferred.
Experience:
- A minimum of 5 years of experience in acute care, managed care, quality management, or related fields is required.
- Familiarity and/or experience with Quality Improvement practices is advantageous.
Licenses and Certifications:
- Hold a current and valid Registered Nurse license to practice in the state of California.
- Possess one of the following certifications:
o Clinical certification in a specialized area
o CPHRM - Certified Healthcare Risk Management
o CJCP - Certified Joint Commission Professional
o CPHQ - Certified Professional Healthcare Quality
Important Notes:
- The provided pay ranges are approximate and subject to adjustments.
- Any mentioned bonuses are exclusively applicable to external candidates meeting the designated criteria.