Supervisor, Clinical Quallity Assurance (Healthcare)
Вакансия из Hirify Global, списка международных tech-компанийДля мэтча и отклика нужен Plus
Мэтч & Сопровод
Для мэтча с этой вакансией нужен Plus
Описание вакансии
TL;DR
Supervisor, Clinical Quallity Assurance (Healthcare): Leading a high-performing team of nurses to guide clinical reviews of medical records and enhance patient education with an accent on HEDIS project management and regulatory compliance. Focus on improving care quality, managing statewide clinical reviews, and leveraging AI-enabled tools to transform member services.
Location: Remote (Preference for candidates located in Tennessee or a contiguous county). Sponsorship is not available for this role.
Company
A leading health insurance provider dedicated to providing high standards of service to members across Tennessee.
What you will do
- Lead a statewide team of nurses in conducting clinical reviews of medical records to enhance documentation and close gaps in care.
- Direct the annual HEDIS project, overseeing hybrid medical record reviews and supplemental data analysis.
- Analyze complex issues and performance measures by running database queries and applying logic.
- Ensure corporate compliance with accreditation and regulatory standards for various enterprise areas.
- Collaborate with provider offices to strengthen patient education and ensure highest service standards.
Requirements
- Registered Nurse (RN) with active license in Tennessee or a participating Nurse Licensure Compact state.
- Bachelor's Degree in a Health Related Discipline (Nursing, Dietetics, Exercise Science, Counseling, Social work, or Health Education).
- Minimum 5 years of clinical nursing experience.
- At least 2 years of supervisory experience and 2 years of project management experience.
- Certification as a Professional in Healthcare Quality, HIAA, or an equivalent certification.
Culture & Benefits
- Remote work flexibility with a regional preference for TN.
- Innovative environment that encourages the responsible use of AI-enabled tools to support daily work.
- Culture of continuous improvement and accountability for professional outcomes.
- Inclusive workplace with strong commitment to equal employment opportunity.
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