Posted by: Sentara on Dec 03, 2019
Virginia Beach, VA
Optima Health is hiring a Registered Nurse (RN) - Quality Improvement (QI) Coordinator to join our Quality Assurance (QA/QI) team in Virginia Beach, VA.
Monday - Friday, 8am-5pm
The ideal Registered Nurse who joins our team will have a solid background and sound understanding of regulatory, accreditation process and various quality related areas to support our managed care services objectives and goals.
Optima Health offers a full suite of commercial health insurance products including employee-owned and employer-sponsored plans, as well as Individual and Family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services.
As a nationally recognized provider of health plan coverage and innovative wellness programs, we live our mission "to improve health everyday." This same commitment and dedication directs our philosophy as an employer. When you join Optima Health, you will experience our deep passion for heal and service excellence while benefiting from a culture of opportunity, learning, career growth, and support -every day. Optima Health is a service of Sentara Healthcare, so joining Optima is joining the Sentara Healthcare family.
Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For more information about our employee benefits, CLICK HERE !
Join our team, where we are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, growth!
Keyword: quality, QI, Registered Nurse, RN, regulatory, QA, auditing, accreditation, managed care, health insurance
Equal Opportunity Employer
Sentara maintains a drug free workplace
The Quality Improvement Coordinator is responsible for coordinating the design, development, implementation, and evaluation of the heath plan's clinical quality functions. Assists in developing focused and/or specialized studies based on high volume, high risk, high cost, and/or problem prone areas, and periodically monitors and evaluates related performance goals. Collaborates with Clinical Care Services to improve health status for chronic diseases based on demographic and epidemiological characteristics of the membership.Assists in maintaining accreditation and certifications for NCQA and MCHIPS, as well as assisting to meet the requirements for state and federal (DMAS and CMS) regulations and requirement.
RN-Bachelor's Level Degree
Required: Clinical - 3 years, Quality Improvement - 3 years
Preferred: None, unless noted in the "Other" section below
Required: Registered Nurse
Knowledge and understanding of regulatory and accreditation processes required
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