At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.
Come join us and be part of a purpose driven company who is invested in your future!
Job Summary
***TELECOMMUTE: This position will work from home 5 days a week. Eligible for the state of Oklahoma ONLY. Candidate will have to pass a WFH speed test.***
*Out of state applications will not be considered.*
This position is responsible for facilitating clinical quality improvement projects and evaluation of Provider/Provider Group compliance with clinical practice guidelines. This role will consult with Medical Groups, physicians, providers, and other resources to assess, plan, facilitate implement, coordinate, monitor and evaluate options and services required to meet clinical quality improvement project objectives.
JOB REQUIREMENTS:
- Registered Nurse (RN), LPN, LVN, Physician's Assistant OR MSW (Master of Social Work)/LCSW (Licensed Clinical Social Worker) or other BH licensure with current, unrestricted license to practice in the state of operations OR Respiratory Therapist with master’s level or above degree
- Medical specialty certification (Certified Professional in Healthcare Quality (CPHQ) or Diabetic Education) OR Bachelor Degree in medical field such as Nursing, Health Care Administration.
- 3 years clinical practice experience.
- 2 years' experience in health insurance or managed care.
- 2 years quality improvement and/or project management experience.
- Experience conducting presentations for member and/or provider training.
- Current unrestricted driver’s license.
- Ability to travel including overnight stays.
- Verbal and written communications skills.
- Data analysis experience.
- PC proficiency to include Word, Excel, and PowerPoint.
PREFERRED EXPERIENCE:
- Licenses Nurse with HEDIS experience HIGHLY PREFERRED
- Health plan QI (qualify improvement) HIGHLY PREFERRED
- HEDIS audit experience.
- Familiarity with EMR (electronic medical record) and Inovalon (HEDIS software)
We encourage people of all backgrounds and experiences to apply.
Even if you don’t think you are a perfect fit, apply anyway - you might have qualifications we haven’t even thought of yet.
*Sponsorship will not be provided for this role.*
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
