A company is looking for a Quality Perform Specialist Clinical.
Key Responsibilities
Lead and coordinate the clinical quality review process of member concerns and medical records
Support annual medical record review activities including HEDIS and Clinical Practice Guidelines
Assist in accreditation and clinical quality performance improvement activities
Required Qualifications
Registered Nurse preferred
3 to 5 years of Managed Care experience
3 to 5 years of quality improvement experience required
2 to 4 years of experience in project facilitation / management role
Proficient with Microsoft Office applications including Word, PowerPoint, and Excel
South Carolina • Huntington Beach, California, United States