Quality Improvement Coordinator II (Healthcare)

Location: Remote-WI; remote work associated with Wisconsin, United States.

Salary: $33.71–$60.67 per hour.

Company

hirify.global provides healthcare services focused on connecting people with accessible care and improving health outcomes.

What you will do

• Conduct quality, service performance, utilization, credentialing, and medical record reviews for delegated entities and healthcare providers.
• Perform onsite quality reviews, investigate complaints and sentinel events, resolve quality-of-care issues, and prepare written findings.
• Audit medical records, review administrative claims, analyze data, and support quality improvement studies and outcome reporting.
• Coordinate community clinical initiatives, act as a liaison with agencies and providers, and chair delegated-entity meetings.
• Develop corrective action plans, oversee contract data submissions, and recommend policy, process, and program enhancements.
• Coordinate Credentialing and Quality Improvement Committee activities and monthly meetings.

Requirements

• Bachelor’s degree in Nursing preferred.
• At least 3 years of clinical, quality improvement, or healthcare experience.
• At least 2 years of experience in a healthcare quality function.
• Abstractions and Overread experience highly preferred.
• MedSurge experience highly preferred.
• Active LPN, LVN, RN, PA, or LCSW license and CPHQ certification are preferred.

Culture & Benefits

• Full-time employment with a flexible remote, hybrid, field, or office work approach.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Work focused on improving healthcare access and outcomes for individuals, families, and communities.