Quality of Care Coordinator

Oklahoma Complete Health; Village of Newark (NY); Remote; USD 60,000 - 80,000; Full time

Job summary

Join a forward-thinking organization as a Quality of Care Coordinator, where your expertise in nursing will directly impact the quality of care for millions. In this pivotal role, you'll review medical records, assess compliance with care standards, and collaborate with medical directors to enhance patient outcomes. Enjoy a flexible work environment with competitive pay and comprehensive benefits, including health insurance and tuition reimbursement. This position offers a unique opportunity to make a difference in healthcare while advancing your career in a supportive and diverse workplace.

Benefits

Health Insurance

401K

Stock Purchase Plans

Tuition Reimbursement

Paid Time Off

Flexible Work Schedules

Qualifications

• 3+ years of experience in nursing or related healthcare experience.
• RN/LCSW certification required; CPHQ preferred.

Responsibilities

• Review medical records for quality of care incidents.
• Compile timelines and summaries for presentation to medical directors.
• Ensure adherence to organizational policies and clinical protocols.

Skills

Nursing

Clinical Knowledge

Quality of Care Assessment

Education

Associate’s degree in Nursing

Bachelor’s degree in Nursing

Job description

Quality of Care Coordinator page is loaded

Quality of Care Coordinator

Apply locations Newark-750 Prides Crossing (11131) Remote-CT Remote-PA Remote-NJ Remote-NY time type Full time posted on Posted 2 Days Ago job requisition id 1565073

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Review medical records for potential Quality of Care (QOC) incidents, applying clinical criteria to determine if a lack of care was present. Utilize clinical knowledge to provide summary of findings and severity level to physicians.

• Review medical records for quality of care incidents by determining if the specified standards of care were met, and assigning an initial severity level of lack of compliance/care
• Compile timeline and summary of incident, including the details of the potential QOC for presentation to the medical director for a final review; may also be involved in peer review committee actions or next steps
• Maintains organizational and program policies and procedures; ensures adherence to prescribed policies and procedures and clinical protocols where appropriate

Education/Experience: Associate’s degree in Nursing required; Bachelor’s degree in Nursing preferred. 3+ years of experience in nursing or related healthcare experience.

License/Certification: RN/LCSW required; CPHQ preferredPay Range: $33.03 - $59.47 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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