LPN QA & Care Improvement Specialist

Health Wealth Safe, Inc.; Bethlehem (Northampton County); On-site; USD 30,000 - 41,000; Full time

Job summary

Health Wealth Safe, Inc. is seeking an experienced Licensed Practical Nurse to oversee quality care initiatives and support HEDIS and prenatal/postpartum measures.

The role involves reviewing medical records, documenting data in a quality database, and collaborating with providers to improve health outcomes. Responsibilities include managing member caseloads, coordinating interventions, and ensuring compliance with NCQA and CMS standards.

Qualifications

• Graduate from a Specialty Training Program in Nursing (required).
• Strong communication, collaboration, and analytical skills are essential for success in this role.

Responsibilities

• Manages quality care initiatives and supports HEDIS and prenatal/postpartum measures.
• Conducts medical record reviews and documents data accurately in the quality database.
• Collaborates with providers and members to improve health outcomes.
• Manages member caseloads and executes targeted interventions.
• Ensures compliance with regulatory guidelines such as NCQA and CMS.
• Promotes preventive health and guideline adherence with staff and members.
• Identifies opportunities for process improvements and quality enhancements.

Skills

LPN experience

Medical record review

Regulatory standards

Computer skills

Education

Specialty nursing program

Job description

Health Wealth Safe, Inc. is seeking an experienced Licensed Practical Nurse to oversee quality care initiatives and support HEDIS and prenatal/postpartum measures.

The role involves reviewing medical records, documenting data in a quality database, and collaborating with providers to improve health outcomes. Responsibilities include managing member caseloads, coordinating interventions, and ensuring compliance with NCQA and CMS standards.