Quality Management Specialist III
At HCSC, building a talent engine for the future is a key priority because we recognize that as our business evolves to reflect the changing world, we must adapt our workforce to meet this challenge. Additionally, with "excellence" one of our core values, we are focused on improving our success measures and delivering the best possible customer experience.
This position is responsible for facilitating BCBS IL clinical quality improvement projects and evaluation of PCP/MG/IPA compliance with BCBS IL clinical practice guidelines; consulting with MG/IPAs, physicians, providers, members, and other resources to assess, plan, facilitate implement, coordinate, monitor and evaluate options and services required to meet clinical quality improvement project objectives; serving as preceptor for less experienced staff, and coordinates special departmental projects.
• Registered Nurse (RN), Licensed Practical Nurse (LPN), Respiratory Therapist, or other medical specialty, i.e. Physicians Assistant, Corpsman with unrestricted license in state.
• Medical specialty certification (Certified Professional in Healthcare Quality (CPHQ) or Diabetic Education) OR Master's Degree in medical field such as Nursing, Health Care Administration.
• 3 years clinical practice experience.
• 3 years experience in health insurance or managed care.
• 3 years quality improvement and/or project management experience.
• Experience developing, planning and conducting presentations for member and/or provider training.
• Current Illinois driver's license.
• Ability to travel including overnight stays.
• Verbal and written communications skills.
• Data analysis experience.
• PC proficiency to include Word, Excel, PowerPoint and Access or database system.
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Requirements: Expertise Quality Assurance Job Type Full-Time Regular Location IL - Chicago
Meet Some of HCSC's Employees
Allison audits operational and financial data throughout the business, helping to expose and mitigate risks, ensure compliance, and add value to HCSC’s operations as a whole.
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