Quality Improvement Coordinator II

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Conduct assessments of delegated entities to ensure adherence to quality, service performance, utilization, and credentialing standards.

• Execute medical record audits and perform quality on-site evaluations of delegated entities, physician practices, and clinics.

• Address quality concerns and produce written summaries of findings.

• Document, investigate, and resolve complaints, risk management issues, and sentinel events pertaining to the quality of care.

• Examine administrative claims and analyze data and interventions for quality improvement studies and initiatives.

• Act as the main point of contact between community resources/agencies and the company for clinical initiatives and technical support.

• Organize and lead meetings with delegated entities in accordance with contract stipulations.

• Collect data and prepare utilization and quality improvement reports.

• Create and execute Corrective Action Plans.

• Suggest modifications to Quality Improvement policies and procedures.

• Identify best practices, explore new processes, and recommend enhancements to programs.

• Coordinate QIC activities and monthly meetings.

• Oversee the enforcement of contract stipulations regarding the submission of delegated-entity data.

• Contribute to the development of reporting and data outcome reports.

• Engage in community events such as health fairs.

• Perform additional duties as assigned.

⛳️ Requirements

• Candidate must reside in Arizona.

• A Bachelor’s degree in Nursing is preferred.

• A minimum of 3 years of clinical, quality improvement, or healthcare experience is required.

• At least 2 years of experience in a quality function within a healthcare setting is essential.

• Preferred licenses include LPN, LVN, RN, PA, or LCSW.

• CPHQ (Certified Professional in Healthcare Quality) certification is preferred.

• Must comply with all policies and standards.

🏝️ Benefits

• Health insurance.

• 401K plan.

• Stock purchase plan.

• Tuition reimbursement.

• Paid time off plus holidays.

• Flexible work arrangements including remote, hybrid, field, or office schedules.

• Additional incentive options may be part of total compensation.

• We are an equal opportunity employer committed to diversity.