Clinical Quality Coordinator - Hybrid Review Specialist

Blue Shield of CA; Lodi (CA); Hybrid; USD 65.000 - 85.000; Vollzeit

Zusammenfassung

Blue Shield of CA is seeking a Clinical Quality Coordinator, Intermediate to support the Clinical Quality Review team in California. You will help manage the process of requesting medical records and provider responses to enable thorough clinical reviews.

The role emphasizes clear communication, attention to detail, and collaboration with providers and internal teams. Hybrid work allows flexible days with periodic in-office presence as needed.

Qualifikationen

• High school diploma or GED or equivalent experience.
• Minimum 3 years of relevant healthcare experience.
• Strong verbal and written communication skills.
• Basic knowledge of PC software (MS Office, Adobe Acrobat).
• Familiarity with managed care (HMO/PPO) and regulatory agencies preferred.

Aufgaben

• Request medical records and responses from providers to facilitate clinical review by CQR staff.

Kenntnisse

Verbal and written communication

Ausbildung

High school diploma or GED

Tools

Microsoft Suite

Adobe Acrobat

Jobbeschreibung

Blue Shield of CA is seeking a Clinical Quality Coordinator, Intermediate to support the Clinical Quality Review team in California. You will help manage the process of requesting medical records and provider responses to enable thorough clinical reviews.

The role emphasizes clear communication, attention to detail, and collaboration with providers and internal teams. Hybrid work allows flexible days with periodic in-office presence as needed.