Quality Improvement Coordinator II – Clinical

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

📋 Description

• Oversee and track quality enhancement and organizational initiatives from their start to completion.

• Create and execute quality improvement programs and initiatives at both corporate and individual health plan levels.

• Support compliance with NCQA/URAC standards.

• Ensure that Quality Improvement policies and procedures adhere to NCQA/URAC requirements.

• Recognize best practices, investigate new processes, and suggest program enhancements.

• Assist throughout the project life cycle, which includes requirements gathering, project planning and scheduling, resource management, execution, deployment, and closure.

• Help with the gathering and presentation of data for designated quality improvement projects.

• Carry out other assigned tasks.

• Adhere to all policies and standards.

⛳️ Requirements

• Candidate must reside in NV.

• Bachelor’s degree in Nursing or a related medical field is preferred.

• At least 3 years of clinical experience.

• Minimum of 1 year of experience in a quality-related role.

• Practical experience in drafting and implementing policies and procedures to support NCQA/URAC or JCAHO accreditation standards is preferred.

• Basic knowledge of the health insurance industry, claims payment processes, strategies, and trends in healthcare is preferred.

• RN, LPN, or LVN credentials.

• Current state nursing license is necessary.

• A valid driver’s license is required.

• CPHQ certification is preferred.

• Understanding of NCQA, URAC, and state regulations.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement assistance.

• Paid time off along with holidays.

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

• Additional incentive opportunities may be included in total compensation.