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Quality Improvement RN Specialist

Company: Lakeside Medical
Location: Orange
Posted on: October 14, 2020

Job Description:

and develops strategies for improvement.* Reviews reports from Health plans or other sources regarding groups' performance; identifies deficiencies, and provides a correction action process.* Collates and analyzes quality and utilization reports for presentation at appropriate committees.* Motivates, educates and provides assistance to appropriate staff, HPN committees and network.* Reviews and updates quality, utilization, and member management policies and procedures manual and creates new policies as needed.* Communicates required changes, develops tools to assess risks, and leverages existing processes to facilitate required changes.* Provides professional/technical guidance to team members and stakeholders.* Communicates and influences acceptance and adherence to policies, practices, procedures of both an interpretive and non-interpretive nature.* Conducts delegated oversight audits for all HPN affiliated medical groups.* Creates Corrective Action Plans for groups as necessary, conducts follow-up and provides education as necessary in conjunction with the appropriate staff.* Assists with health plan delegated oversight audits for all HPN affiliated medical groups.* Assists in developing and presenting educational presentations for the groups and committees, as needed.* Works with groups to standardize policies, programs and activities across the network.* Contributes to the achievement of department objectives.* Other duties as assignedEducation and/or Experience :* Graduate from accredited school for Nursing* Active California RN license* Minimum of 3-5 years of Clinical experience* Minimum of 1 year of Quality Management experience* Minimum of 3-5 years of Managed Healthcare experience* Proficient in Microsoft Word ,Excel & PowerPoint

Keywords: Lakeside Medical, Orange , Quality Improvement RN Specialist, Healthcare , Orange, California

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