The QI Nurse Coordinator serves as the primary staff member accountable for the daily implementation of Cook Children's Health Plan's (CCHP) Quality Management Work Plan.Specifically, the Coordinator completes concurrent and retrospective reviews of clinical quality and issues within the health plan.This position works closely with the CCHP Director of Quality Improvement, Quality Program Lead, Medical Director, other health plan staff, network physicians and other providers to identify clinical quality issues and recommend actions for improvement.
3-5 years' experience in the healthcare field; experience quality improvement, utilization management, or care management in a managed care setting.
Experience with children with special healthcare needs strongly preferred.
Knowledge of local and national quality management and regulatory standards, including NCQA and HEDIS reporting.
Demonstrated analytical ability in identifying problems, developing solutions, implementing effective courses of action, and leading project teams.
Strong communication skills required, including the ability to effectively communicate verbally and in writing, internally and externally, and with varied educational levels in mind.
Strong knowledge of MS Office, including large-scale database management required.
Proficiency in Access and SQL preferred.
nowledge of Lean, Six Sigma, CQI Principles, and Project Management strongly preferred.