Job Description
Description:
The Quality Nurse Specialist will be an integral member of the Peak Healths quality team.
This position is responsible for overseeing performance improvement activities, ensuring regulatory compliance, and other initiatives that lead to effective clinical resource utilization and improvements in quality.
These duties may include but are not limited to HEDIS/Stars oversight, committee support, performance monitoring and assessment, data collection and analysis, and the continual advancement of the quality improvement process to achieve Peak Healths goals of excellence.
Requirements:
Current unencumbered licensure with the WV Board of Registered Nurse Professional Nurses, or appropriate state board where services will be provided, as a Registered Nurse professional OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC)
Five (5) years of healthcare clinical experience
Knowledge of CMS guidelines, regulations, NCQA® and HEDIS®
Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN) or Diploma; Currently enrolled in a BSN program and BSN completion within three (3) years of hire
Managed Care knowledge or experience
2-3 years Quality Management, Quality Improvement or Process Improvement Experience
Benefits:
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