BlueCross BlueShield of South Carolina RN Quality Improvement Coordinator in Columbia, South Carolina

RN Quality Improvement Coordinator

Position Summary

  • Monitors/implements quality improvement/management activities.

  • Conducts specific medical reviews as necessary, analyzes findings, makes recommendations for corrective actions and prepares formal documentation for compliance with applicable standards/regulations.

  • Performs Health Plan Employer Data Information Set (HEDIS) data collection and National Committee for Quality Assurance (NCQA) accreditation activities.

Required Education

  • Associate degree in nursing.

Preferred:

  • Bachelor's degree in nursing.

Required Work Experience

  • Four years of clinical experience, to include two years of quality management experience.

Preferred:

  • HEDIS knowledge.

  • Medical record review and provider education experience.

Required Skills and Abilities

  • Excellent oral and written communications, customer-service, organizational, presentation, problem-solving and analytical or critical-thinking skills.

  • Proficient in spelling, grammar, punctuation and basic business math.

  • Ability to handle confidential or sensitive information with discretion.

  • Demonstrated ability to identify the need for and to implement corrective actions.

  • Strong understanding of managed care.

  • Microsoft Office skills.

  • Active, unrestricted RN license from the United States and in the state of hire, OR

  • An active, compact, multistate, unrestricted RN license as defined by the Nurse Licensure Compact (NLC).

Work City Columbia

Work State SC

EEO Statement

We are an Equal Opportunity/Affirmative Action Employer. We will consider all qualified applicants for employment regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status.