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POSITION SUMMARY/RESPONSIBILITIES
Coordinates and collaborates with Community First Health Plans, Inc. (Community First), various departments to ensure that contractual, regulatory, and accreditation requirements, including National Committee for Quality Assurance (NCQA) and Healthcare Effectiveness Data and Information Set (HEDIS) are met as it pertains to the Quality Management Department. Monitors Community First performance on various quality metrics and benchmarks them against state and federal standards. Provides ongoing management of data collection systems and the development of procedures for monitoring, validating, and reconciling data for accuracy. May serve as a leader/facilitator of process improvement efforts. Provides oversight of and performs functions of review, investigation, and analysis of member-level clinical care data and provider performance as it compares to standards of care.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required. Bachelor's degree in nursing, clinical informatics, or other health care, or other health care related field is preferred. Five or more years of relevant healthcare experience is required. Experience in data analysis and preparation of quality improvement or related reports is preferred. Experience with Microsoft Office (Outlook, Word, Excel). Excellent communication and interpersonal skills are required. Quality Management certification such as CPHQ or CHCQM is preferred. Working knowledge of continuous process improvement principles and standard coding products is preferred.
LICENSURE
Current licensure as a Registered Nurse in the State of Texas is required.
Other
Ancillary Healthcare
$97k-123k (estimate)
03/19/2024
05/18/2024
cfhp.com
SAN ANTONIO, TX
50 - 100
1995
NGO/NPO/NFP/Organization/Association
RICHARD CESPEDES
$50M - $200M
Ancillary Healthcare
CFHP is a non-profit Health Maintenance Organization that offers health care coverage services for individuals and families.
The job skills required for Quality Management Nurse I include Health Care, Clinical Nursing, Quality Improvement, Microsoft Office, Quality Management, etc. Having related job skills and expertise will give you an advantage when applying to be a Quality Management Nurse I. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Quality Management Nurse I. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Quality Management Nurse I positions, which can be used as a reference in future career path planning. As a Quality Management Nurse I, it can be promoted into senior positions as a Top Quality Management Executive - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Quality Management Nurse I. You can explore the career advancement for a Quality Management Nurse I below and select your interested title to get hiring information.