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Clinical Quality Improvement Coordinator (Option to work remote)

Apply now Job no: 495399
Employment type: Regular
Location: Omaha, Nebraska
Categories: Nursing

Blue Cross and Blue Shield of Nebraska (BCBSNE) is more than just an insurance company with a solid foundation; our sights are set on reinventing what health care can and should be. As the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there’s no greater time for forward-thinking professionals like you to join us.

Our employees champion change and are inspired to transform the communities we serve every day. As a member of “the Blues Crew,” you’ll find purpose, opportunities and the support you need to build a meaningful career. Learn more about our culture and what makes BCBSNE such an exceptional place to work by visiting NebraskaBlue.com/Careers.

This position functions within Healthcare Delivery and Wellness by developing and implementing quality improvement activities, analyzing data, fulfilling documentation requirements for accreditation and the Quality Management Program, promoting health and wellness initiatives, coordinating collaborative projects to improve health care quality and transparency, investigating quality of care issues and providing internal and external customer support.  This position must exceed customer expectations, be cross-functional, and adapt to ever changing corporate and market demands.

What you'll do: 

  • Develop, implement and monitor health care quality programs in collaboration with internal and external stakeholders, including BCBSA and/or network providers to improve quality of care and services for members, improve population health and reduce the cost of care.
  • Design, develop, monitor, document and report on clinical quality assessment and improvement activities as required by the Quality Management Program, regulatory and accreditation standards and contract deliverables.
  • Contribute to the Quality Management Program activities, Quality Management Committee, quality strategy and work plan, and related reporting within defined deadlines. Complete special projects as assigned.
  • Investigate, monitor, document and report on quality of care and service issues regarding health care and services rendered within the BCBSNE provider networks.
  • Communicate with internal and external stakeholders at all levels, both verbally and in writing, regarding quality of care, service issues, and quality improvement initiatives.
  • Promote a culture of preventive health and wellness both in and out of BCBSNE through support of BCBSNE wellness program initiatives
  • Limited travel is required

To be considered for this position, you must have all of the following:

  • Associate’s degree in nursing or related health care field 
  • Five years of experience in health care quality, performance improvement, patient safety, risk management, utilization management, or case management in a health care organization or health plan. 

The strongest candidates for this position will also possess:

  • Bachelor’s degree in nursing or a related field
  • Current licensure or certification appropriate to clinical education (RN, LPN, etc.)
  • CPHQ (Certified Professional in Health Care Quality)

We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.

Blue Cross and Blue Shield of Nebraska is an Equal Opportunity /Affirmative Action Employer - Minorities/Females/Disabled/Veterans

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