Organization: Gold Coast Health Plan
Location: Camarillo, CA
Date Job Posted: August 29, 2022
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RN, Quality Improvement
Full Time Regular
Camarillo, CA, US
Requisition ID: 1375
The Quality Improvement (QI) Nurse will support the Quality Improvement Program, assisting the health plan to successfully achieve organizational objectives for quality and patient safety. This position will be responsible for core clinical functions within the Quality Improvement department, including quality reviews, reporting, and performance improvement activities. The Quality Improvement (QI) Nurse will work closely with the Director of Quality Improvement and the Chief Medical Officer to assess the Quality Improvement Program's outcomes, identify areas of needed improvement, and institute actions to promote the delivery of high quality care. This employee must be able to interpret the requirements of the Plan's regulatory bodies, and state and federal regulations, and institute processes/ programs to ensure compliance.
Reasonable Accommodations Statement
To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.
Essential Functions Statement(s)
SKILLS & ABILITIES
Education: Bachelor's Degree (four year college or technical school) Required, Field of Study: Nursing or related field
Experience: 3 plus years of clinical experience in Quality Improvement, Risk Management, Compliance, and/or Accreditation demonstrating increasing responsibility in clinical quality improvement.
Computer Skills: Personal computer skills with competency in the MS Office software including Word, Excel, PowerPoint, and Access.
Certifications & Licenses: Current and active California Registered Nurse (RN) License required. Valid California Driver's License required.
Knowledge of quality improvement processes and risk mitigation strategies in a managed care environment.
Knowledge of DHCS requirements, NCQA Accreditation standards, and HEDIS.
Analytical and problem solving acumen.
Excellent verbal and written communication skills and ability to interact in a positive manner within the medical/clinic community.
Team player who builds effective working relationships within and across teams.
Ability to work independently.
Strong organizational skills and ability to multi-task
Ability to analyze, interpret, apply and communicate policies, procedures and regulations.
Understanding and ability to perform data analysis, basic statistical skills including intermediate knowledge of Excel.
Proven experience with performance improvement methodologies required.