Join our Medical Management/Health Services team as a Clinical Excellence Coordinator and help improve care for 28 million members. This hybrid role involves critical quality improvement activities, provider education, and ensuring compliance with healthcare standards.
Key Responsibilities
Conduct member and/or provider outreach to close quality care gaps
Coordinate member access to healthcare providers
Document clinical information in medical management systems
Ensure compliance with state regulations
Educate providers on HEDIS measures and documentation requirements
Collect and summarize performance data for quality improvement
Required Qualifications
Bachelor’s degree in Health Care, Nursing, Public Health Administration or Business
3 years of experience in healthcare
Licenses: LPC, LCPC, LCSW, or RN
Preferred Qualifications
2+ years in a lead role
Experience in managed care environment
Project management experience
Benefits & Perks
Competitive payHealth insurance401K and stock purchase plansTuition reimbursementPaid time off plus holidaysFlexible work schedules