CenCal Health
Clinical Improvement Specialist
CenCal Health, Santa Barbara, California, us, 93190
CenCal Health is a publicly-funded managed care organization that provides health care coverage for residents in Santa Barbara and San Luis Obispo counties. We are currently seeking a Claims Customer Service Supervisor in our Santa Barbara office location.Job Description
We're looking for a RN that likes to make visits to local providers/clinics to upgrade our quality of care for our members. Need to have 2+ years experience in healthcare field, outpatient care a plus. Are you good at understanding clinical issues and medical diagnosis? Performed chart audits? We've got an opportunity for you!Qualifications
This role has a requirement of being in office 1 day per month in Santa Barbara.Strong team-oriented ability to connect with quality improvement staff, and establish and maintain positive professional working relationships, both within and outside CenCal Health.Knowledge of quality improvement theory, strategy, and practical methods to achieve rapid-cycle improvement.Ability to perform effectively under pressure and maintain focus on daily responsibilities for long-term projects.Ability to establish and nurture positive professional working relationships with CenCal Health customers.Ability to evaluate data, establish facts and draw valid conclusions.Effective oral and written communication skills.Ability to perform HEDIS medical record data abstraction.Education and Experience
Bachelor’s Degree in a job-related field.2 years’ experience in a managed care quality management setting (or combination of academic, professional or work experience that demonstrates ability to perform the duties of the position).Current and unrestricted Registered Nurse (RN) license to practice in California.Desired Qualifications
A graduate degree in a healthcare- or management-related discipline is preferred (e.g., MBA, MPH).Certified Professional in Healthcare Quality (CPHQ) or similar certification.An emphasis in Medicaid/Medi-Cal managed care.Salary Range
$78,562 - $121,771Additional Information
To view our current job openings, please visit our website at www.cencalhealh.org.
#J-18808-Ljbffr
We're looking for a RN that likes to make visits to local providers/clinics to upgrade our quality of care for our members. Need to have 2+ years experience in healthcare field, outpatient care a plus. Are you good at understanding clinical issues and medical diagnosis? Performed chart audits? We've got an opportunity for you!Qualifications
This role has a requirement of being in office 1 day per month in Santa Barbara.Strong team-oriented ability to connect with quality improvement staff, and establish and maintain positive professional working relationships, both within and outside CenCal Health.Knowledge of quality improvement theory, strategy, and practical methods to achieve rapid-cycle improvement.Ability to perform effectively under pressure and maintain focus on daily responsibilities for long-term projects.Ability to establish and nurture positive professional working relationships with CenCal Health customers.Ability to evaluate data, establish facts and draw valid conclusions.Effective oral and written communication skills.Ability to perform HEDIS medical record data abstraction.Education and Experience
Bachelor’s Degree in a job-related field.2 years’ experience in a managed care quality management setting (or combination of academic, professional or work experience that demonstrates ability to perform the duties of the position).Current and unrestricted Registered Nurse (RN) license to practice in California.Desired Qualifications
A graduate degree in a healthcare- or management-related discipline is preferred (e.g., MBA, MPH).Certified Professional in Healthcare Quality (CPHQ) or similar certification.An emphasis in Medicaid/Medi-Cal managed care.Salary Range
$78,562 - $121,771Additional Information
To view our current job openings, please visit our website at www.cencalhealh.org.
#J-18808-Ljbffr