Nurse Quality Management & Data Improvement

University Health; Pleasanton (TX); On-site; USD 90,000 - 120,000; Full time

Job summary

Community First Health Plans, Inc. requires a qualified Nursing professional to ensure NCQA and HEDIS compliance, coordinating with multiple departments to meet contractual and regulatory standards.

The role includes overseeing data collection systems and leading process-improvement efforts to enhance quality of care. Ideal candidates will have a Texas RN license, 5+ years in healthcare, and experience with data analysis and quality reporting; CPHQ/CHCQM preferred.

Qualifications

• Graduation from an accredited school of professional nursing is required.
• Bachelor's degree in nursing, clinical informatics, or other health care related field is preferred.
• Five or more years of relevant healthcare experience is required.
• Experience with data analysis and preparation of quality improvement reports is preferred.
• Quality Management certification such as CPHQ or CHCQM is preferred.

Responsibilities

• Coordinate with Community First Health Plans, Inc. to meet NCQA and HEDIS requirements.
• Monitor quality metrics and benchmark against state and federal standards.
• Manage data collection systems and develop procedures for monitoring, validating, and reconciling data for accuracy.
• Lead or facilitate process improvement initiatives as needed.
• Review, investigate, and analyze member-level clinical care data as compared to standards of care.

Skills

Data analysis

Communication

Interpersonal skills

Process improvement

Leadership

Education

Bachelors in Nursing

Clinical informatics or related health field

Tools

Microsoft Office

Job description

Community First Health Plans, Inc. requires a qualified Nursing professional to ensure NCQA and HEDIS compliance, coordinating with multiple departments to meet contractual and regulatory standards.

The role includes overseeing data collection systems and leading process-improvement efforts to enhance quality of care. Ideal candidates will have a Texas RN license, 5+ years in healthcare, and experience with data analysis and quality reporting; CPHQ/CHCQM preferred.