Quality Management Specialist III

Quality Management Specialist III - Chicago, IL

This position is responsible for facilitating BCBSIL clinical quality improvement projects and evaluation of PCP/MG/IPA compliance with BCBSIL 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 Masters 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 drivers 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 Government Programs Job Type Full-Time Regular Location IL - Chicago

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