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RN Quality Management Coordinator, Insurance Services - Fresno California

Company: Community Health System - CA
Location: Fresno, California
Posted On: 04/25/2024

Overview:
*All positions are located in Fresno/Clovis CA*

Opportunities for you!

  • Join a Forbes Top 10 CA Employer!
  • Tuition reimbursement, education programs, and scholarships
  • Vacation time starts building on Day 1, and builds with your seniority
  • 403(b) retirement plan with up to 8% matching contributions
  • Free parking and electric charging
  • Great food options with on-demand ordering

    Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

    We know that our ability to provide the highest level of care begins with taking care of our incredible teams. Want to learn more? Click here.
    Responsibilities:
    The RN Quality Management Coordinator is responsible for overseeing clinical activities as they relate to quality management and improvement, with significant emphasis on regulatory requirements of our governing entities. Provides support and guidance to assist the Quality Improvement Director to manage multiple functions that enhance cost effectiveness, ensure compliance with applicable state and federal regulatory requirements and improves health outcomes of CCH membership. Supports quality programs by remaining current in internal and external quality standards and programs, such as HEDIS, AMP, NCQA and other relevant programs.

    Qualifications:
    Education
    --- High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required
    --- Bachelor's Degree in Nursing (BSN) preferred

    Experience
    --- 5 years of acute care, managed care, quality or related experience required
    --- Understanding and/or experience with Quality Improvement preferred

    Licenses and Certifications
    --- RN - Current and valid Registered Nurse license to work within the state of California required
    --- One of the following is preferred

    o Clinical certification in area specialty

    o CPHRM - Certified Healthcare Risk Management

    o CJCP - Certified Joint Commission Professional

    o CPHQ - Certified Professional Healthcare Quality
    Disclaimers:
    --- Pay ranges listed are an estimate and subject to change.
    --- If any bonuses are noted, they are only applicable to external hires meeting criteria. More...

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