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Clinical Quality Management Analyst - Remote

Posted 3 weeks ago
All others
Full Time
USA
$68,200.00 - $109,100.00/year

Overview

The Clinical Quality Management Analyst plays a vital role in supporting the development and maintenance of a high-performing quality provider network by engaging with healthcare providers to promote quality improvement initiatives.

In Short

  • Engage with Accountable Care Organizations (ACOs) and primary care providers.
  • Promote quality improvement for NCQA measures.
  • Implement and manage Quality Management activities.
  • Provide education on quality management and preventive health initiatives.
  • Collaborate with stakeholders to streamline healthcare processes.
  • Utilize data analysis tools to present actionable feedback.
  • Participate in quality improvement activities.
  • Travel up to 30% within assigned territories.
  • Maintain relationships with providers to enhance satisfaction.
  • Support the development of quality management programs.

Requirements

  • RN with 3 years of clinical experience or LPN with 5 years of clinical experience.
  • Previous experience in quality programs or related fields.
  • Bachelor’s degree preferred.
  • Proficiency in Microsoft Excel.
  • Clinical data abstraction experience preferred.
  • Billing and CPT II coding experience preferred.
  • EMR analyst experience preferred.
  • Provider-facing clinical quality improvement experience preferred.

Benefits

  • Annual Incentive Bonus based on performance.
  • 401(k) with employer match.
  • Paid Time Off (PTO).
  • Competitive health benefits.
  • Wellness programs.

N.H.A.L.D.B.C.N

NC Health Affiliates LLC DBA Blue Cross NC

NC Health Affiliates LLC, doing business as Blue Cross NC, is a not-for-profit health insurance provider headquartered in Durham, North Carolina. With a commitment to improving health care and the well-being of its members, Blue Cross NC serves over 4.3 million individuals and employs more than 5,000 dedicated professionals. The company is at the forefront of health care transformation, offering innovative solutions and services that go beyond traditional health insurance. Blue Cross NC fosters a dynamic work environment that encourages creativity and collaboration, aiming to lead the charge for better health care in communities across the state and beyond.

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