Blue Cross Blue Shield of Nebraska is seeking a Clinical Quality Improvement Coordinator.
This position functions within Healthcare Delivery and Wellness by developing and implementing quality improvement activities, analyzing data, fulfilling documentation requirements for accreditation and the Quality Management Program, promoting health and wellness initiatives, coordinating collaborative projects to improve health care quality and transparency, investigating quality of care issues and providing internal and external customer support. This position must exceed customer expectations, be cross-functional, and adapt to ever changing corporate and market demands. This position is not a work-from-home eligible role at this time.
What you’ll do:
- Develop, implement and monitor health care quality programs in collaboration with internal and external stakeholders, including BCBSA and/or network providers to improve quality of care and services for members, improve population health and reduce the cost of care.
- Design, develop, monitor, document and report on clinical quality assessment and improvement activities as required by the Quality Management Program, regulatory and accreditation standards and contract deliverables.
- Contribute to the Quality Management Program activities, Quality Management Committee, quality strategy and work plan, and related reporting within defined deadlines. Complete special projects as assigned.
- Investigate, monitor, document and report on quality of care and service issues regarding health care and services rendered within the BCBSNE provider networks.
- Must be able to communicate with internal and external stakeholders at all levels, both verbally and in writing, regarding quality of care, service issues, and quality improvement initiatives.
- Promote a culture of preventive health and wellness both in and out of BCBSNE through support of BCBSNE wellness program initiatives and participation in community health organizations as assigned.
To be considered for this position, you must have:
- Bachelor’s degree in nursing, health information management, or related health care field
- Five years of experience in health care quality, performance improvement, patient safety, risk management, utilization management, case management or health data analysis in a health care organization or health plan.
- An equivalent combination of education and experience may be substituted to meet this requirement.
The strongest candidates for this position will also possess:
- Current licensure or certification appropriate to clinical education (examples: RN, LPN, RHIA, MLT, RT, RPh)
- CPHQ (Certified Professional in Health Care Quality)
- Master’s Degree in a healthcare related field
View the full job description and apply online here.