Quality Management Nurse Consultant
Core
Applies clinical and quality improvement expertise to monitor healthcare services, analyze organizational performance, and drive initiatives to achieve HEDIS and CAHPS goals.
Role type
Quality Management Nurse Consultant (Clinical Quality & Performance Improvement)
Builds
Quality improvement programs, performance interventions, and policy guidelines for healthcare services and network providers.
Domain
Healthcare / Managed Care Quality
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
HEDIS and STARs measures expertise, clinical quality management, quantitative and qualitative data analytics, regulatory and accreditation standards knowledge, evidence-based performance improvement, policy development, stakeholder collaboration, training and education delivery
Preferred skills
Master's degree in healthcare, Certified Professional in Healthcare Quality (CPHQ) certification
Technologies
HEDIS, STARs, CAHPS
Responsibilities
Develop and implement quality improvement programs to monitor and improve healthcare services; Drive evidence-based interventions to reduce care variations and enhance clinical effectiveness; Manage and coordinate workplans for assigned quality councils; Contribute to policy development focusing on system performance and health disparities; Provide training on HEDIS and CAHPS performance metrics; Collaborate with stakeholders to evaluate best practice interventions.
Seniority
Mid-Senior level, hands-on IC
