Quality Assurance Specialist
1 week ago
You could be the one who transforms healthcare for millions. Arizona Complete Health is revolutionizing community health, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose:
- Conduct thorough reviews of delegated entities for compliance with quality standards, service performance, and utilization.
- Perform on-site inspections of physician offices/clinics, resolve quality issues, generate detailed reports of findings, and follow up as directed by senior leadership.
- Audit medical records, review administrative claims, analyze data, and intervene in quality improvement initiatives.
- Serve as the primary liaison between community resources/agencies and the company for clinical initiatives and technical guidance.
- Schedule and chair meetings with delegated entities in accordance with their contract terms.
- Gather data, compile various quality improvement reports, and identify areas for enhancement.
- Develop and implement corrective action plans.
- Recommend changes/enhancements to quality improvement policies and procedures.
- Identify best practices, research new processes, and recommend program enhancements.
- Coordinate activities and monthly meetings related to quality improvement initiatives.
**Salary Range:** $32.41 - $58.31 per hour
About the RoleWe are seeking a highly skilled Clinical Quality Improvement Lead to join our team. This role is responsible for conducting thorough reviews of delegated entities, performing on-site inspections, auditing medical records, and serving as the primary liaison between community resources/agencies and the company.
Requirements**Education/Experience:)
- Bachelor's degree in Nursing preferred. 3+ years of clinical, quality improvement, or healthcare experience. 2+ years of experience in quality function in a healthcare setting.
**License/Certification:** LPN, LVN, RN, PA, or LCSW license preferred. CPHQ (Certified Professional in Healthcare Quality) preferred.
We offer a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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