Remote Clinical Quality Improvement Analyst

Blue Cross and Blue Shield of North Carolina; Virginia; Remoto; USD 74.000 - 118.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, and vision coverage

401k match

Parental leave and adoption support

Tuition reimbursement

Descrizione del lavoro

Blue Cross NC seeks a Clinical Quality Management Analyst to evaluate and monitor staff and provider performance, delivering feedback and action plans to improve quality and compliance. The role supports learning solutions and aligns clinical decisions with regulatory requirements while overseeing data-driven performance metrics.

The ideal candidate holds an RN with 3 years of clinical experience or an LPN with 5 years, plus a relevant degree.

Competenze

• RN with 3 years of clinical experience or LPN with 5 years of clinical experience required.
• Must have previous work experience in applicable business area (i.e. UM, CM, Medical Review or quality programs).
• Bachelor's degree or advanced degree preferred.

Mansioni

• Conduct quality audits of staff and providers to ensure compliance with departmental objectives, regulatory requirements, policies, and procedures.
• Support development of learning solutions based on quality audit findings and performance gaps.
• Monitor, analyze and report individual and department performance results including benchmarking and trend analysis.

Conoscenze

RN with clinical experience

LPN with clinical experience

Formazione

Bachelor's degree or advanced degree

Descrizione del lavoro

Blue Cross NC seeks a Clinical Quality Management Analyst to evaluate and monitor staff and provider performance, delivering feedback and action plans to improve quality and compliance. The role supports learning solutions and aligns clinical decisions with regulatory requirements while overseeing data-driven performance metrics.

The ideal candidate holds an RN with 3 years of clinical experience or an LPN with 5 years, plus a relevant degree.