South Carolina Licensed Quality Specialist

A company is looking for a Quality Perform Specialist Clinical.

Key Responsibilities

Lead and coordinate the clinical quality review process of member concerns and medical records

Support annual medical record review activities including HEDIS and Clinical Practice Guidelines

Assist in accreditation and clinical quality performance improvement activities

Required Qualifications

Registered Nurse preferred

3 to 5 years of Managed Care experience

3 to 5 years of quality improvement experience required

2 to 4 years of experience in project facilitation / management role

Proficient with Microsoft Office applications including Word, PowerPoint, and Excel