Quality Improvement Coordinator /Registered Nurse (RN) for the Health Plan - Remote in Virginia
Core
Leading multi-year quality improvement initiatives, conducting medical record reviews for EPSDT compliance, and investigating critical incidents to ensure regulatory compliance and improve population health outcomes.
Role type
Quality Improvement Coordinator / Registered Nurse (RN)
Builds
Quality improvement projects, regulatory reports, and corrective action plans for Virginia Medicaid members
Domain
Healthcare / Medicaid / Quality Improvement
Deliverable
dashboards & analysis
Required skills
Project management, Data analysis, Root cause analysis, Regulatory compliance, Medical record review, Stakeholder engagement
Preferred skills
Clinical nursing background, Knowledge of DMAS and CMS regulations, Experience with quality improvement methodologies
Technologies
Excel, Project management tools, Quality tracking databases
Responsibilities
Lead and manage multi-year quality improvement initiatives; Conduct monthly EPSDT provider documentation medical record reviews; Coordinate and investigate critical incidents and quality of care concerns; Develop and maintain reports and dashboards to monitor performance; Ensure compliance with DMAS and CMS regulations
Seniority
Mid-level, hands-on IC
