[Remote] Clinical Quality Study Analyst

Note: The job is a remote job and is open to candidates in USA. TriWest Healthcare Alliance is dedicated to serving America's heroes through healthcare solutions. The Clinical Quality Study Analyst role involves conducting quality studies and improvement projects to ensure compliance with Clinical Quality Management standards for Veterans and DoD beneficiaries.ResponsibilitiesConducts research and writes clinical quality studies to identify, develop and evaluate processes to improve delivery of care to Veterans and/or DoD beneficiariesActs as facilitator on quality improvement team projects and utilizes appropriate quality improvement methodologies and standardized quality management toolsLeads and performs quality management auditsIdentifies, develops, and monitors focused reviews and other quality studiesIdentifies Potential Quality Issues (PQIs) by performing a timely review of the medical records. This includes researching, investigating, analyzing, and preparing case summaries with recommendations for further reviewReviews Potential Quality Issues with Medical Directors when appropriatePrepares peer reviewed cases for quality committees and monitors corrective action plansUses data management software to identify physician practice patterns, over- and under-utilization of care and services, complication rates, and high-cost outliersPrepares and submits activity and projects reportsPerforms other duties as assignedRegular and reliable attendance is requiredSkillsRegistered Nurse with current unrestricted license in appropriate state1 year experience in Quality Management1 year experience in data analysis and writing clinical quality studies5 years Medical/Surgical experienceUS citizenship and a favorably adjudicated DOD background investigation if selected to work under TRICARE/DoD ContractBachelor's degree in Nursing or CPHQExperience with team facilitation and project managementExperience with Medicare, Veteran's Administration, TRICARE, or other government health care programsBenefitsMedical, Dental and Vision CoveragePaid time off401(k) Retirement Savings Plan (with matching)Short-term and long-term disability, basic life, and accidental death and dismemberment insuranceTuition reimbursementPaid volunteer timeFrequent pay raisesOvertime opportunities to earn even moreRecognition and reward programsCompany OverviewTriWest Healthcare Alliance - Serving Those Who Serve. At TriWest, we honor the sacrifice and service of our nations military families by It was founded in 1996, and is headquartered in Phoenix, Arizona, USA, with a workforce of 1001-5000 employees. Its website is http://triwest.com.