Blue Cross and Blue Shield of Illinois, Montana, N Quality Management Specialist II in Albuquerque, New Mexico


* This is an on-site position that is in office in Albuquerque, NM. *BASIC FUNCTION: This position is responsible for facilitating BCBS clinical quality improvement projects and evaluation of PCP/MG/IPA compliance with BCBS clinical practice guidelines; consults with MG/IPAs, physicians, providers, members, and other resources to assess, plan, facilitate implement, coordinate, monitor and evaluate options and services required to meet clinical quality improvement project objectives; serves as preceptor for less experienced staff. JOB REQUIREMENTS: * Registered Nurse (RN), Licensed Practical Nurse (LPN), Respiratory Therapist, or other medical specialty, i.e. Physicians Assistant, Corpsman with unrestricted license in state. * Medical specialty certification (Certified Professional in Healthcare Quality (CPHQ) or Diabetic Education) OR Bachelor Degree in medical field such as Nursing, Health Care Administration. * 3 years clinical practice experience. * 2 years experience in health insurance or managed care. * 2 years quality improvement and/or project management experience. * Experience conducting presentations for member and/or provider training. * Verbal and written communications skills. * Data analysis experience. * PC proficiency to include Word, Excel, and PowerPoint. PREFERRED JOB REQUIREMENTS: *Experience with Quality Measures or HEDIS Measures.

Location: NM - Albuquerque

Activation Date: Tuesday, February 20, 2018

Expiration Date: Saturday, March 31, 2018

Apply Here