Full-Time

Quality Improvement Nurse

Registered Nurse

Posted on 10/31/2025

Central California Alliance for Health

Central California Alliance for Health

No salary listed

No H1B Sponsorship

California, USA

Hybrid

Hybrid work environment; some in-office presence may be required depending on business need.

Category
Medical, Clinical & Veterinary (1)
Requirements
  • Current, unrestricted license as a Registered Nurse issued by the State of California
  • Bachelor’s degree in Nursing and a minimum of three years of experience as a Registered Nurse in acute care or primary care with an emphasis on preventative care; a Master’s degree may substitute for two years of the required experience; or an equivalent combination of education and experience
Responsibilities
  • Develops, manages, and measures a comprehensive healthcare strategy in alignment with Department of Health Care Services standards of care and in collaboration with internal stakeholders and network providers to promote best evidence-based practices and improve member health outcomes
  • Evaluates patient safety and quality issues and communicates findings to internal stakeholders, network providers and community partners
Desired Qualifications
  • Experience in process improvement, practice coaching, or health care quality improvement
  • Experience performing PQI activities
  • Working knowledge of managed care, the Medi-Cal program, and related policy
  • Working knowledge of the methods of conducting and interpreting quantitative and qualitative analysis
  • Some knowledge of NCQA HEDIS abstracting guidelines
  • Some knowledge of CPT and ICD coding principles
Central California Alliance for Health

Central California Alliance for Health

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Simplify's Take

What believers are saying

  • $44.9 million invested in 2025 expands care access and strengthens local health infrastructure.
  • Value-based care incentive programs position Alliance to capture outcome-based reimbursement as payers shift models.
  • Geographic diversification into Monterey County opens new revenue streams and member acquisition opportunities.

What critics are saying

  • California Medi-Cal redetermination unwinds 10-20% member base within 6-12 months post-pandemic.
  • L.A. Care's aggressive expansion into Monterey and Santa Cruz counties directly poaches primary networks.
  • State budget deficit triggers 15% capitation rate cuts, eroding $800M revenue base by mid-2026.

What makes Central California Alliance for Health unique

  • Regional scale of 430,000+ Medi-Cal members across five-county service area enables provider negotiation leverage.
  • Housing Fund and Community Health Worker programs address social determinants beyond traditional managed care.
  • 30-year operational history as regional Medi-Cal plan demonstrates sustained execution in complex market.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Ample Paid Time Off

12 Paid Holidays per year

401(a) Retirement Plan

457 Deferred Compensation Plan

Robust Health and Wellness Program

Onsite EV Charging Stations

INACTIVE