Employer Industry: Health Insurance

Why consider this job opportunity:
- Competitive salary with opportunities for bonuses
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on healthcare quality and member experience
- Engaging in meaningful work that aligns with improving health and inspiring hope

What to Expect (Job Responsibilities):
- Develop and implement quality improvement strategies that align with the employer's strategic goals
- Monitor, analyze, and report on quality improvement activities to ensure compliance with regulatory and contractual requirements
- Review and abstract clinical data from medical records while maintaining a high accuracy rate
- Assist in the annual development of performance improvement initiatives and the Quality Work Plan
- Participate in internal and external quality improvement audits

What is Required (Qualifications):
- Bachelor’s Degree in nursing preferred
- Current RN license in Massachusetts
- Minimum of 3-5 years of experience in a Managed Care setting
- Quality management or performance improvement experience required
- Strong clinical, interpersonal, analytical, and communication skills

How to Stand Out (Preferred Qualifications):
- CPHQ certification preferred
- Lean-Six Sigma certification preferred
- Experience with medical record review and proven results

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