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Quality Improvement Coordinator (x3) in Pittsburgh, PA at APEX Systems

Date Posted: 6/14/2019

Job Snapshot

Job Description

Job #:  963035

I am looking for a Quality Improvement Coordinator for Centene Corporation in Pittsburgh, PA! If you feel as though you are a good fit please apply. 
Summary: Provide support for the Quality Department to perform improvement and review procedures
Job Responsibilities: Conduct internal record reviews and audits, including medical records. Review records to ensure they are complete, accurate and compliant with standards Initiate SOP revisions to ensure they are current and validated and support continuous improvement Develop and enhance documentation, tracking tools and process flows for quality monitoring activities to comply with current regulations and standards Maintain databases and spreadsheets to track and trend quality monitoring activities, results and outcomes Analyze data and develop reports to support QI program Complete special projects or assignments as needed to meet initiatives and/or objectives of department Identify, problem-solve and communicate to direct supervisor any issues that are interfering with project deadlines or project scopeEducation/Experience: Associate’s degree in Business, Healthcare or equivalent experience. Familiar with Quality Improvement philosophy and techniques and key continuous quality improvement (CQI) concepts. Skilled in Microsoft Office products.5-7 years of experience

• What will be the primary day-to-day responsibilities entail for this person?
Position Purpose: Analyze, develop, implement and monitor clinical quality improvement initiatives to achieve healthy outcomes.

Perform duties and functions to comply with quality improvement programs according to state requirements.
Support Quality Assurance Performance Improvement work plan/initiatives.
Schedule and assist with committee and sub-committee preparation.
Assist in investigation and resolution of member quality of care complaints.
Audit medical records and monitor performance measures for health care risk management, sentinel events and trends.

For PA H&W only:
Responsible for overseeing reporting and outcome measurement and HEDIS data collection, serving as point person between the Department and the Department’s EQR contractor.

Education/Experience: Bachelor’s degree in nursing preferred. 2+ years clinical, quality management or healthcare related experience. At least one year experience in quality function in a healthcare setting. 

License/Certification: LPN, LVN, RN, PA, or LCSW license preferred. Utilization management certification preferred. Certified Professional in Healthcare Quality preferred.
Please reach out if you have any questions!
EEO Employer
Apex is an Equal Employment Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at 844-463-6178-6178.