Clinical Improvement Specialist

CenCal Health

$78K — $121K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree in a job-related field
  • 2 years' experience in a managed care quality management setting
  • Current and unrestricted RN license to practice in California
  • Ability to evaluate data and draw valid conclusions
  • Strong oral and written communication skills
  • Team-oriented with a focus on building relationships
  • Knowledge of quality improvement strategies and methods

Responsibilities

  • Visit local providers and clinics to enhance the quality of care for members
  • Perform chart audits to identify clinical issues and medical diagnoses
  • Collaborate with quality improvement staff and maintain professional relationships
  • Evaluate data for quality improvement initiatives
  • Maintain focus on responsibilities for long-term projects
  • Communicate effectively with both healthcare professionals and members
  • Support Medicaid/Medi-Cal managed care initiatives

Benefits

  • Work from home with in-office requirement of only one day per month
  • Opportunity for professional development in quality improvement
  • Mentorship from experienced quality management staff
  • Access to a network of healthcare providers and clinics
  • Engagement in meaningful work that directly impacts member care
Full Job Description
  • We're looking for a RN that likes to make visits to local providers/clinics to upgrade our quality of care for our members. Need to have 2+ years experience in healthcare field, outpatient care a plus. Are you good at understanding clinical issues and medical diagnosis? Performed chart audits? We've got an opportunity for you!


Qualifications

This role has a requirement of being in office 1 day per month in Santa Barbara
  • Strong team-oriented ability to
    connect with quality improvement staff, and establish and maintain positive
    professional working relationships, both within and outside CenCal Health
  • Knowledge of quality improvement
    theory, strategy, and practical methods to achieve rapid-cycle improvement;
  • Ability to perform effectively under
    pressure and maintain focus on daily responsibilities for long-term projects;
  • Ability to establish and nurture
    positive professional working relationships with CenCal Health customers;
  • Ability to evaluate data,
    establish facts and draw valid conclusions;
  • Effective oral and written
    communication skills;
  • Ability to perform HEDIS medical


Education and Experience
  • Bachelor's Degree in ajob-related field
  • 2 years' experience in a managed care quality management setting (or combination of academic, professional or work experience that demonstrates ability to perform the duties of the position.
  • Current and unrestricted Registered Nurse (RN) license to practice in California

DESIRED:
  • A graduate degree in a
    healthcare- or management-related discipline is preferred (e.g., MBA, MPH)
  • Certified Professional in
    Healthcare Quality (CPHQ) or similar certification
  • HEDIS medical record data abstraction


An emphasis in Medicaid/Medi-Cal managed care

Salary Range: $78,562 - $121,771

Additional Information

To view our current job openings, please visit our website at www.cencalhealh.org.

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