Clinical Quality Improvement Specialist RN
Location: Jacksonville Florida
Description: Blue Cross Blue Shield of Florida is currently seeking to employ Clinical Quality Improvement Specialist RN right now, this occupation will be placed in Florida. More complete informations about this occupation opportunity please read the description below. -
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Description
Job duties include but are not limited to the following:
- Performs quality assessments for physicians, facility and ancillary providers taking into account all available information internal and external to the organization.
- Provides leadership for and collaborates with network management, internal staff and /or other key stakeholders (both internal and external) to define potential quality improvement activities within the corporation.
- Leads the full spectrum of various quality improvement initiatives to include collaboration, design, implementation, monitoring and relationship management.
- Performs clinical quality assessment analysis customer inquiries, peer review findings, publicly available data, industry information and others and provide findings to key stakeholders.
- Performs medical chart reviews where necessary to support improvement and compliance related activities.
- Accountable for delivery of strategies, plans and improvements to Health Plan Employer Data Information Set (HEDIS) & Consumer Assessment of Health Plan Stability (CAHPS), Health Outcome Survey (HOS), Medicare Stars and other quality measurements to include: data pursuit of strategy, barrier analysis, interventions for rate improvement and monitoring and evaluation; collaboration with other corporate initiatives.
- Develop initiatives to improve clinical performance and reduce variation in the delivery of health care by adhering to evidenced based medical guidelines.
- Moderate to heavy keying required
- Current Florida RN License
- 4+ years’ experience in health insurance or managed care (defined as previous experience with health plan/hospital compliance, risk management)
- Valid Florida's driver's license and reliable transportation
- Clinical experience
- Bachelor's degree in related field such as Nursing, Health Care Administration, or Business Administration
- Proficient at Microsoft Word, Excel, PowerPoint
- Six Sigma-Green belt certification
- Project Management experience
Jacksonville
Other Locations
Pensacola, Ft. Myers, Gainesville, Ft. Lauderdale, Sarasota, West Palm Beach, Tallahassee, Lake Mary, Miami, Tampa
Organization
Blue Cross Blue Shield of Fla
Schedule
Full-time
Posting Deadline
Jul 31, 2012, 10:59:59 PM
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If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Blue Cross Blue Shield of Florida.
If you interested on this occupation just click on the Apply button, you will be redirected to the official website
This occupation starts available on: Mon, 23 Jul 2012 18:31:04 GMT