Healthcare Quality Improvement Coordinator (Hybrid)

Cambia Health Solutions, Inc.; Lewiston (ID); Ibrido; USD 66.000 - 108.000; Tempo pieno

Descrizione del lavoro

Cambia Health Solutions, Inc. in multiple offices across the West invites applicants for a Quality Improvement Coordinator. The role turns QA and audit findings into improvement initiatives across Claims, Membership, and Customer Service.

You'll partner with staff and leaders to strengthen processes, monitor quality measures, and drive measurable improvements that enhance member and provider experiences.

Competenze

• Bachelor's degree or equivalent work experience in health care insurance industry.
• At least five years of experience in Claims, Membership, and/or Customer Service relevant to audit responsibilities.
• At least three years of Quality Assurance, Quality Improvement, or Quality Management experience.
• Claims, Membership, Customer Service, or Multi-Service experience is preferred.

Mansioni

• Analyze QA and external audit results to identify defects, trends, root causes, and measurable opportunities for improvement.
• Develop and maintain quality improvement initiatives, plans, reports, and long-term goals in partnership with staff and management.
• Manage and facilitate quality improvement projects to strengthen Member Services processes, improve member and provider satisfaction, and increase business productivity.
• Monitor quality measures, prioritize projects that maximize return on investment, and report progress and accomplishments to Quality Assurance and Member Services management.
• Assess the scope and potential frequency or financial impact of processing errors, then recommend feasible corrective actions.
• Initiate and track system enhancements and upgrades that support quality, including coordination, testing, implementation, reporting, documentation, and training activities.
• Build strong working relationships across Member Services, Quality Assurance, Reporting, and Internal Audit, and participate in calibration meetings and quality summits as needed.

Conoscenze

Quality Improvement

Root cause analysis

Statistical analysis

SQL

Excel

Communication skills

Facilitation

Project management

Formazione

Bachelor's degree in business, health care, communications, or related field

Strumenti

Microsoft Word

Microsoft Excel

Outlook

Microsoft Access

Descrizione del lavoro

Cambia Health Solutions, Inc. in multiple offices across the West invites applicants for a Quality Improvement Coordinator. The role turns QA and audit findings into improvement initiatives across Claims, Membership, and Customer Service.

You'll partner with staff and leaders to strengthen processes, monitor quality measures, and drive measurable improvements that enhance member and provider experiences.