Clinical Process Improv Spec
Posted on: June 8, 2021
Job ID: WS-1042211
This role must be located in either Downers Grove, Chicago or
the Richardson, TX local areas. This will be considered a hybrid
role for work space once offices are re-opened.
This position is responsible for developing and evaluating
clinical business processes to support the cost of care, quality,
compliance and financial performance strategy for the
divisional/enterprise care management operations. Responsible for
providing independent, objective evaluation and consultative
services that enhance business performance, minimize risk and
optimize care management programs/services/interventions.
Collaborate with clinical operations management, EHCM Learning and
Development, and Culture and Engagement teams in identification and
implementation of best cost of care management practices. Develop
methodologies and tools to monitor performance and prepare
- Registered Nurse (RN) with current, unrestricted clinical
license to practice in state of operations.
- 2 years clinical experience.
- 1 year clinical auditing or managed care experience.
- Knowledge of managed care operations.
- Analytical skills to effectively identify improvement
opportunities and root cause.
- Verbal and written communication skills to work across the
division, collaborate with management, develop executive
- PC experience utilizing Microsoft Office software.
PREFERRED JOB REQUIREMENTS:
- Experience in accreditation and Quality standards under URAC,
NCQA and JCAHO and applying those standards in an operational
- Bachelor Degree in Nursing or Health Administration or in the
- Managed care experience with working knowledge of managed care
and UM/CM policies and practices.
- Certified Professional Health Care Quality (CPHQ
- Six Sigma training or certification.
- Ability to travel including overnight stays, as needed.
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.
Expertise Audit, Nursing Job Type Full-Time Regular Location IL
- Downers Grove, TX - Dallas, TX - Richardson, IL - Chicago
Keywords: HCSC, Richardson , Clinical Process Improv Spec, Other , Richardson, Texas
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