Clinical Quality Prog Admin

WellPoint is the nation's leading health benefits company serving the needs of approximately 28 million medical members nationwide.

Position maybe located in Richmond, Virginia or Atlanta, Georgia location

 

Responsible for overseeing the quality improvement activities/projects as outlined in the QI work plan and as required by applicable law, regulations and accreditation standards. Primary duties may include, but are not limited to: Ensures integration of quality into the overall business process. Performs assessments to identify gaps in the enterprises quality and technology assessment processes and initiates actions to correct these gaps. Assures accuracy and completeness of input provided to internal and external QI committees and timely implementation of appropriate interventions to effect improvement. Oversees the clinical quality improvement activities/projects to implement appropriate clinical interventions to improve the quality of care for members. Assures compliance with corporate QI work plans. Assures that all QI activities are relevant to the needs of targeted population. Assures compliance to Practice Guideline, Delegation and Continuity and Coordination of care Standards. Maintains effective documentation of research programs to meet regulatory and Accreditation Standards Provides oversight to assure accurate and complete quantitative analysis of clinical data, presentation of results of data analysis. May provide oversight to the HEDIS project team. BA/BS with a minimum of 3 years in a health care data analysis required, or any combination of education and experience, which would provide an equivalent background. RN license required. Masters degree in Health Management preferred.