Quality Management Analyst (Clinical)

Clinical Quality Management Analyst Job Description: • This job works with appropriate departments in the areas of compliance, process improvement, medical record review and coding, and member and provider satisfaction for all product lines. • Recommends and implements process improvements related to the potential of quality medical care and service to members and to improve documentation of these services for appropriate ICD 10-CM coding. Qualifications: • This is a medical review position. Will be mining medical records • Must be a Registered Nurse in PA • Must have 3-5 years of medical review experience • Must have HEDIS experience • Must have medical review experience • Must have Customer service experience • Must have attention to detail • Must be proficient in Excel • Must be tech savvy • Quality improvement experience preferred • Must complete the Clinical Quality Management Analyst Assessment.

Job Type: Contract Pay: From $30.00 per hour Expected hours: 40 per week Application Question(s): • Do you have a laptop for a glider assessment? • Will you be able to complete the assessment after the call? Education: • Bachelor's (Required)

Experience: • Medical Review: 3 years (Required) • HEDIS: 3 years (Required) • Customer service: 3 years (Required) License/Certification: • RN License (Required) Work Location:

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