Portland, OR; Seattle, WA; Tacoma, WA; Burlington, WA; Lewiston, ID
Bring your experience to a role where you will:
- Develop and implement quality improvement programs related to clinical quality outcomes and assists in resolving deficiencies that impact plan compliance to regulatory and accreditation standards.
- Ensure activities meet regulatory requirements of the state or product and reflects Cambia's quality strategies, approaches and work plans.
- Knowledge of quality improvement processes and performance measurement and ability to develop and accomplish clinical quality program activities.
- Demonstrated ability to identify problems, develop solutions and implement a chosen course of action.
- Leadership skills with the ability to direct activities of others both individually and within a project team.
- Ability to organize, plan, prioritize and develop multiple projects within time constraints.
- Strong data abstraction and quantitative, qualitative and analytical skills.
- Knowledge of the healthcare industry, preferably in the managed care market.
- Excellent verbal and written communication skills including ability to communicate effectively across multiple areas and levels.
- Participation in successful NCQA/URAC accreditation process and continuous process improvement experience in an NCQA/URAC setting highly preferred.
Normally to be proficient in the competencies listed above:
- Quality Clinician would have a/an Associate or bachelor's degree in Nursing or related field and 3 years of progressive experience in health care administration, quality, project management or project support or equivalent combination of education and experience.
Required Licenses, Certifications, Registration, Etc.
- Clinical licensure or certification in a health or human services discipline (in a state or territory of the United States) that allows the professional to conduct an assessment independently as permitted within the scope of practice for the discipline (e.g. medical vs. behavioral health) and at least 3 years (or full time equivalent of direct clinical care.
- Must have at least one of the following:
- Bachelors' degree (or higher) in a health or human services field (psychiatric RN or Masters degree in Behavioral health preferred for behavioral health); or
- Current unrestricted Registered nurse (RN) license
- Certified Professional in Healthcare Quality (CPHQ) preferred.
Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required.
Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members more than 90 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.
If you're seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers' engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.
Apply Here: http://www.Click2apply.net/ww64r76sjzsgkk9n