Quality Improvement Coordinator I (RN)

Location: Pittsburgh, PA, United States
Position Purpose: Analyze, develop, implement and monitor clinical quality improvement initiatives to achieve healthy outcomes.
  • Perform duties and functions to comply with quality improvement programs according to state requirements.
  • Support Quality Assurance Performance Improvement work plan/initiatives.
  • Schedule and assist with committee and sub-committee preparation.
  • Assist in investigation and resolution of member quality of care complaints.
  • Audit medical records and monitor performance measures for health care risk management, sentinel events and trends.

For PA H&W only:
Responsible for overseeing reporting and outcome measurement and HEDIS data collection, serving as point person between the Department and the Department’s EQR contractor.

Qualifications:
Education/Experience:
  • Bachelor’s degree in nursing preferred.
  • 2+ years clinical, quality management or healthcare related experience.
  • At least one year experience in quality function in a healthcare setting. 

License/Certification: LPN, LVN, RN, PA, or LCSW license preferred. Utilization management certification preferred. Certified Professional in Healthcare Quality preferred.

For PA H&W Only: Pennsylvania-licensed physician, RN, or physician's assistant with past experience or education in QM systems. At the CHC-MCO’s request, the Department may consider other advanced degrees relevant to QM in lieu of professional licensure.
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