Clinical Improvement Specialist
Company Description CenCal Health is a publicly-funded managed care organization that provides health care coverage for residents in Santa Barbara and San Luis Obispo counties. We are currently seeking a Claims Customer Service Supervisor in our Santa Barbara office location. 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. Apply tot his job