Why consider this job opportunity Opportunity for career advancement and growth within the organization
Supportive and collaborative work environment
Engage in meaningful work that positively impacts member health outcomes
Potential for travel, allowing for diverse experiences in community interactions
Comprehensive benefits and compensation package
What to Expect (Job Responsibilities) Implement evidence-based member intervention strategies and manage community interventions
Monitor and ensure timely completion of key member intervention activities
Write narrative reports to interpret regulatory specifications and document program findings
Participate in quality improvement activities and collaborate with other departments
Evaluate project activities to identify opportunities for improvement and support high-quality clinical care
What is Required (Qualifications) Associate’s degree or equivalent combination of education and work experience
1-3 years’ experience in healthcare with at least 1 year in health plan quality member interventions or managed care
Demonstrated solid business writing experience
Operational knowledge and experience with Excel and Visio
Excellent problem-solving skills
How to Stand Out (Preferred Qualifications) Bachelor’s Degree in Nursing, Social Work, Clinical Quality, Public Health, or Healthcare Administration
1 year of experience in Medicare and Medicaid managed care
Certified Professional in Health Quality (CPHQ)
Nursing License (RN may be preferred for specific roles)
Certified HEDIS Compliance Auditor (CHCA)
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