Quality Team Leader and Trainer (Philadelphia, PA)
Location: Philadelphia Pennsylvania
Description: Cigna is presently looking of Quality Team Leader and Trainer (Philadelphia, PA) right now, this job will be placed in Pennsylvania. Further informations about this job opportunity please read the description below. Job Description
Responsible for conducting the functions of Quality Management in a timely, efficient manner and ensuring achievement of QM objectives. Specific responsibilities include, but are not limited to: creating and maintaining quality management files; reviewing all potential QM cases; performing special studies or audits; conducting office site visits and medical records reviews, supporting preparations for regulatory audits. Leads clinical quality improvement through focused activities on the HEDIS proces! s and other clinical studies. Evaluate the need for clinical i! ntervention and, as appropriate, assess, analyze, plan, implement and evaluate intervention options to assure success. Identify actions required to improve performance and work with regional and national teams to improve results. Define and document policies, procedures and processes. Current LVN/LPN/RN with B.S. degree or equivalent work experience. Three to five years of quality review and improvement experience preferred. Experience with NCQA standards, quality management preferred. Strong project management, research and analytical skills. .
Responsibilities:
Responsible for scheduling and coordinating medical record reviews and on-site practice coordinator audits and/or overseeing these audits and ensuring quality and compliance.
Responsible for capturing and monitoring P4Q quality metrics.
Assists in the production of action plans for department audits deficiencies.
Evaluates performance of staff, including providers, dep! artments, and staff.
Provides and maintains communication with providers, departments, and staff.
Assists in improving operation workflows and streamlining work processes.
Responsible for creating presentations, communication, and educational material for on-going training/education.
Schedules and coordinates medical record reviews and onsite practice coordinator audits.
Produces action plans for department audits deficiencies.
Trains and mentors new employees and reinforce database training as needed.
Assists with data extraction and data entry.
Coordinates and participates in internal and external meetings.
Assists with onboarding new physician practices and participates in physician/PODs meetings.
Creates and participates in internal and external meetings.
Assists with initial audits when new physician practices are added to the program.
Other duties as assigned by! the P4Q Quality Manager.
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Requirements
Minim! um Requirements:
Licensed Practical Nurse (LPN) or Registered Nurse (RN) license required
At least two years related experience in a healthcare environment.
Written and oral communication skills; ability to handle multiple tasks, set priorities, and develop action items; detailed oriented; works independently with minimum supervision.
Excellent communication and problem solving skills.
Ability to travel to and work at participating practices in Mid- Atlantic region (MD, DC, DE, and PA).
Experience with Microsoft Word, Excel, and Power Point.
50 percent travel requirement.
Preferred Requirements
Current licensure as a Registered Nurse (RN) or BSN, in applicable state.
Minimum of three years clinical practice experience in provider’s office or hospital setting.
Previous leadership/management experience.
Previous training/mentoring experience.
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If ! you were eligible to this job, please email us your resume, with salary requirements and a resume to Cigna.
If you interested on this job just click on the Apply button, you will be redirected to the official website
This job starts available on: Tue, 03 Dec 2013 18:22:12 GMT
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