RN /LPNQuality Management Sr Specialist (Manager)-HealthSpring-
Location: Mobile Alabama
Description: Cigna is in need of RN /LPNQuality Management Sr Specialist (Manager)-HealthSpring- right now, this occupation will be placed in Alabama. For detail informations about this occupation opportunity kindly read the description below. Job Description
Role Summary
Assists in the development, implementation, management, and coordination of the Pa! rtnership for Quality (P4Q) program activities and data collection..
Responsibilities
Monitors the day to day activities across the program. Assigns staff based on priority. Keeps up with needed baseline audits and plans for new physician groups joining the program. Maintains training materials. Evaluates the effectiveness of the P4Q program by finding creative ways to trend current available information and works with corporate to implement any changes in the program. Works with network operations and advises of any changes in the program or staff. Supports the P4Q supervisors with managing locations and database issues. Maintains departmental workflows. Assists with RADV audits. Follows local, federal and company policies and procedures to maintain compliance. Develops action plans for any compliance issues. Monitors all reporting requirements across the department. Explains dashboard numbers. Attends physician and internal meetings. Knowledgeable regard! ing P4Q contracts. Elevates program to the next level by inclu! ding clinical skills of field staff to impact member outcomes, including utilizing onsite and case management nurses. Maximizes member interactions with PCP office. Works with senior plan medical director to find ways to engage members in both preventive and chronic care measures. Requirements
Qualifications
Minimum Requirements: Unrestricted Licensed Practical Nurse (LPN) Licensure or Licensed Vocational Nurse (LVN) for the state of Alabama. At least 3 years of healthcare experience. Supervisory experience strongly preferred. Written and oral communication skills; ability to handle multiple tasks, set priorities, and develop action items; detailed oriented; works independently with minimum of supervision; critical thinking skills to plan and accomplish goals. Ability to travel within the state and adjoining counties,
Preferred Requirements: Unrestricted Registered Nurse (RN) Licensure for the state of Alabame. Two years of quality e! xperience. Managed care experience. Claims payment and/or contracting experience.
Certification as a Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or Certified Professional in Healthcare Quality (CPHQ) is a plus but not required..
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If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Cigna.
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This occupation starts available on: Wed, 13 Mar 2013 00:16:00 GMT
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