Full-Time

Clinical Quality Improvement Coordinator

Posted on 11/20/2024

Blue Cross Blue Shield

Blue Cross Blue Shield

1,001-5,000 employees

Healthcare

Junior, Mid

Remote in USA

Remote work option available in Florida, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and Texas.

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Requirements
  • Bachelor's degree in nursing, health information management, or related health care field
  • Two or more (2+) years experience in health care quality and performance improvement, patient safety, risk management, utilization management, case management or health data analysis in a health care organization or health plan.
  • An equivalent combination of education and experience may be substituted for this requirement.
  • The ability to meet or exceed the attendance and timeliness requirements of their departments.
  • The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers.
  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and or ability required.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Responsibilities
  • Develop, implement and monitor health care quality programs in collaboration with internal and external stakeholders including network providers to improve quality of care and services for members, improve population health and reduce the cost of care.
  • Design, develop, monitor, document and report on clinical quality assessment and improvement activities as required by the Quality Management Program, regulatory and accreditation standards and contract deliverables.
  • Contribute to the Quality Management Program activities, Quality Management Committee, quality strategy and work plan, and related reporting within defined deadlines. Complete special projects as assigned.
  • Investigate, monitor, document and report on quality of care and service issues regarding health care and services rendered within the BCBSNE provider networks.
  • Communicate with internal and external stakeholders at all levels, both verbally and in writing, regarding quality of care, service issues, and quality improvement initiatives.
  • Promote a culture of preventive health and wellness both in and out of BCBSNE through support of wellness program initiatives.
Blue Cross Blue Shield

Blue Cross Blue Shield

View

Company Stage

N/A

Total Funding

N/A

Headquarters

Chicago, Illinois

Founded

1910

Growth & Insights
Headcount

6 month growth

0%

1 year growth

0%

2 year growth

0%
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Simplify's Take

What believers are saying

  • Partnership with Folx Health expands access to LGBT-affirming care.
  • Collaboration with American Spine Registry improves service offerings and competitive edge.
  • Promotion of Michael Gardner to VP, Enterprise Data enhances data-driven decision-making.

What critics are saying

  • Class action lawsuit over anti-competitive practices poses financial and reputational risks.
  • $2.8 billion antitrust settlement increases scrutiny from regulatory bodies.
  • Data privacy concerns arise from collaboration with American Spine Registry.

What makes Blue Cross Blue Shield unique

  • Blue Cross Blue Shield partners with Folx Health for LGBT-affirming care expansion.
  • Collaboration with American Spine Registry enhances Blue Distinction Centers' evaluation.
  • Blue Distinction Centers for Excellence highlight commitment to quality healthcare services.

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