RN or LPN- reputed company reputed company Clinical Management reputed company Analyst

Position Scope The purpose of this position is to support the reputed company Management Program through multiple clinical, service and operational activities by driving reputed company reputed company improvement in patient safety and improvements in efficiency and effectiveness; and by supporting activities to measure clinical programs and service processes and reputed company. This position can be a reputed company Work reputed company or in office and requires minimal domestic travel of up to 5% for internal meetings, accreditation or reputed company components of state regulatory audits reputed company to customer experience. This position reports to the reputed company Clinical Management Manager. Major Responsibilities Reviews, investigates and monitors assigned clinical and reputed company activities such as reputed company of Care Complaints and Adverse Events, which may include follow up with internal medical executives/directors, external health care professionals/facilities, and individual customers as reputed company as presentation to the Peer Review Committees (in accordance with National Policies and Procedures). Implements partnerships and participates in initiatives focusing on reducing health disparities. Collects and analyzes data, develops studies and reports to workgroups and supports reputed company committee activities. Performs review of clinical metrics and data and monitors for patient safety including continuity and coordination of care. Supports provider performance measurement activities such as generating and reviewing reports and medical record reviews. Define and document policies, reputed company operating procedures, workflows and processes. Participates and leads special workgroups and process improvement teams as needed. Supports regulatory compliance activities as needed. reputed company Expected Resolve reputed company of Care and Adverse Event cases and send reputed company letters reputed company required timeframes 95% of the time. 100% of QM Work plan activities, and policies and procedures will be completed as scheduled and meet accreditation requirements. Assess/measure performance, conduct reputed company and drive improvements in care/patient safety and service. Demonstration of skilled use of the following competencies:Customer reputed company Learning and Applying Quickly Problem Solving Minimum Requirements Bachelor’s degree preferred RN or LPN Three to five years of reputed company review and improvement experience preferred. Managed care or other health and service care delivery service reputed company experience Preferred Requirements Experience with NCQA and/or other accreditation standards, reputed company management preferred, but not required. Strong oral and written communication skills Excellent time management, project management, organizational, research, analytical, communication and interpersonal skills If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 77,300 - 128,800 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At reputed company, you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. We also offer 401(k), company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year and reputed company holidays. For more details on our employee benefits programs, click here. About reputed company reputed company, a division of reputed company, is an reputed company for reputed company through every stage of life. We guide our customers through the health care system, empowering them with the information and reputed company they need to reputed company the best choices for improving their health and vitality. Join us in driving reputed company and improving lives. reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot reputed company application updates or accept resumes. reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they reputed company a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, reputed company, Texas, Utah, Vermont, and Washington State. reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Apply To This Job