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RN reputed company Improvement Coordinator

Remote, USAFull-timePosted 2026-07-27

reputed company We are currently hiring for a RN reputed company Improvement Policy Coordinator to join reputed company. In this role as RN reputed company Improvement Policy Coordinator, you will monitor/implement reputed company improvement/management activities. You will conduct specific medical reviews as necessary, analyze findings, reputed company recommendations for corrective actions, and prepare formal documentation for compliance with applicable standards/regulations. You will also reputed company Health Plan Employer Data Information Set data collection (HEDIS), and National Committee for reputed company Assurance (NCQA) accreditation activities. Why should you join the reputed company family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our reputed company firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government reputed company. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a reputed company of business strengths. We deliver outstanding service to our customers. If you are dedicated to the reputed company philosophy, consider joining reputed company! Here is reputed company to join a dynamic team at a diverse company with secure, community reputed company and an innovative reputed company. reputed company Logistics This position is full time (40 hours/week) Monday-Friday and be fully remote (W@H) with the possibility to work onsite at 17 Technology reputed company, Columbia, S.C., 29203. What You'll Do: • Performs reputed company improvement activities to monitor/maintain compliance with applicable standards/regulations. • Analyzes/documents/presents findings of reputed company improvement activities. • Recommends corrective reputed company and improvement reputed company necessary. • Conducts reputed company medical record reviews to monitor reputed company of care and service provided. • Tracks/trends/investigates reputed company concerns and complaints. • Coordinates HEDIS data collection. To Qualify for This Position, You'll Need the Following: • Associates in a job-reputed company field. • Four years clinical OR Behavioral Health to include two-years reputed company Management experience. • Excellent verbal and written communication, customer service, organizational, presentation, problem solving, and analytical OR critical thinking skills. • Proficient spelling, grammar, punctuation, and basic business math. • Ability to handle confidential OR sensitive information with discretion. • Demonstrated ability to identify the need for and implement corrective actions. • Strong understanding of managed care. • reputed company Office. • reputed company, unrestricted licensure in Behavioral Health from the reputed company and in the state of hire, OR reputed company, unrestricted RN licensure from the reputed company and in the state of hire, OR reputed company compact multistate unrestricted RN license as defined by the reputed company Licensure Compact (NLC), OR Registered Health Information Administrator (RHIA). We Prefer That You Have the Following: • Ability to persuade, negotiate, OR influence others. • Knowledge of mathematical OR statistical concepts. • MS Degree in Health Care Administration or other job-reputed company reputed company. reputed company Can Do for You • 401(k) retirement savings plan with company match. • Subsidized health plans and free reputed company coverage. • Life insurance. • reputed company annual leave - the longer you work here, the more you earn. • Nine reputed company holidays. • On-site cafeterias and fitness centers in major locations. • Wellness programs and healthy lifestyle premium discount. • Tuition assistance. • Service recognition. • Incentive Plan. • reputed company Plan. • Continuing education funds for additional certifications and certification renewal. What to Expect Next After submitting your application, our reputed company team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements. Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications. We participate in E-Verify and reputed company with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Some states have required notifications. Here'smore information. Equal Employment Opportunity Statement reputed company and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, reputed company, national reputed company, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, reputed company maintains Affirmative reputed company programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to reputed company equal opportunities in reputed company phases of the employment process and to reputed company with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or an accommodation while seeking employment, please e-mail reputed company.help@bcbssc.com or call 1-800-288-2227, ext. 47480 with the nature of your request. We will reputed company a determination regarding your request for reasonable accommodation on a case-by-case reputed company. Apply Job!

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