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19 Performance Improvement Specialist jobs match your search criteria.

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Job Description: Nurse Practitioner (NP) Nurse Practitioner (NP) Location: Port Chester, NY Salary:  Experience: 1.0 year(s) Job Type: Temporary / Consulting Job ID: J137541       About the Opportunity A premier school in Port Chester, NY is seeking a self-motivated and compassionate Nurse Practitioner (NP) for a promising opportunity on their staff. In this role, the NP will provide high quality primary care to adolescent age patients enrolled in the school's health program. Apply today! Company Description School Job Description The Nurse Practitioner (NP) will: Share in the responsibility of site administration with other members of the healthcare team Provide comprehensive patient care and establish a family/school partnership to meet the needs of the patients are met on an ongoing basis Ensure high quality primary care is delivered cost-effectively, consistently Provide appropriate specialist referrals, follow-up and hospitalization when indicated Maintain electronic medical records Engage patient, family and cross-functional care teams in sustained health and well-being of the patient Partner with team and school resources Maintain familiarity with ongoing research and development in relevant fields Ensure performance improvement initiatives are supported with timely and accurate data and consistent actions Required Skills Active New York State Family or Pediatric Nurse Practitioner license Adolescent experience as an NP Focused on collaborative team-based care Responsive and comfortable working in a fast-paced, high accountability environment Proficient in EHR systems Excellent judgment and ability to prioritize resources where they will be most useful Comfortable receiving and providing constructive feedback Engaged in learning and continuous quality improvement Outstanding written and verbal communications skills Passionate about providing high quality primary health care to low-income, under-served residents and those lacking access to health care Desired Skills Bilingual, English and Spanish

Job Description: Credentialing Specialist Credentialing Specialist Location: Farmington, CT Salary:  Experience: 2. year(s) Job Type: Temporary / Consulting Job ID: U1008627       About the Opportunity A Connecticut-based healthcare company is looking to fill an immediate need with the addition of a new Credentialing Coordinator to their staff. In this role, the Credentialing Coordinator will be responsible for ensuring that the credentialing / re-credentialing process of practitioners and Health Delivery Organizations (HDO) is carried out efficiently and effectively to meet State and Federal standards, and in accordance with NCQA and Corporate policies. Apply today! Company Description Healthcare Company Job Description The Credentialing Coordinator will be responsible for: Establishing and maintaining a system for timely processing of credentialing and re-credentialing files in accordance with the company, CMS and NCQA policies Ensuring that providers/HDOs on the company's participating panel are in compliance with the company policies and NCQA and state and federal regulatory standards Maintaining current knowledge of NCQA, State and Federal requirements Performing data entry in and maintaining currency of the database for tracking practitioner / HDO credentialing and re-credentialing information Initiating and conducting primary source verification of provider credentials Reviewing credentialing and re-credentialing applications against CCI credentialing standards to determine if candidates are appropriate for the company's practitioner panel and processes applications accordingly Assembling all verified information and prepares files for presentation to the Medical Director and/or the company's Quality Improvement Committee for approval or recommendation to not credential Maintaining communications with provider offices to promote relationships imperative to process Modifying and designing reports and queries to demonstrate the effectiveness of the credentialing / re-credentialing process Required Skills 2+ years of previous experience in a Health Insurance environment, preferably in provider relations or credentialing Associate's Degree or an equivalent combination of education and experience Computer savvy Working knowledge of Amisys Advanced Solid knowledge of Medical terminology Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Able to multitask efficiently and effectively Desired Skills Experience in Provider Relations or Credentialing Knowledge of NCQA and CMS requirements

Job Description: Quality Information Specialist Quality Information Specialist Location: Cocoa Beach, FL Salary:  Experience: 0.0 year(s) Job Type: Temporary / Consulting Job ID: U1015295       About the Opportunity An established managed care company located in Cocoa Beach, FL is actively seeking a diligent and patient-oriented Nurse to join their staff as a Quality Information Specialist. In this role, the Quality Information Specialist establishes and fosters a healthy working relationship between large physician practices, IPAs and the company. Apply today! Company Description Managed Care Company Job Description The Quality Information Specialist: Advises and educates large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters) Delivers provider specific metrics and coach providers on gap closing opportunities Develops, enhances and maintains provider clinical relationship across product lines Leads and/or supports collaborative business partnerships, elicit client understanding and insight to advise and make recommendations Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Captures concerns and issues in action plans as agreed upon by provider Documents action plans and details of visits and outcomes and reports critical incidents and information regarding quality of care issues Required Skills Bachelor's Degree in Nursing  or equivalent work experience of 3+ years directly related HEDIS record collection with analytical review/evaluation and/or Quality Improvement 2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff 1+ year of experience in Managed Care experience Active Registered or Practical Nurse license; or Acute Care Nurse Practitioner license Demonstrated interpersonal/verbal communication skills Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Proficient in Microsoft Office Knowledge of healthcare delivery Understanding of data analysis and continuous quality improvement process Desired Skills Health Care Quality and Management Certified Healthcare Professional Certified Professional in Healthcare Quality

Job Description: Quality Information Specialist Quality Information Specialist Location: Jacksonville, FL Salary:  Experience: 2.0 year(s) Job Type: Temporary / Consulting Job ID: U1014668       About the Opportunity An established managed care organization located in Jacksonville, FL is actively seeking a compassionate and driven healthcare professional for a promising opportunity on their staff as a Quality Information Specialist. In this role, the Quality Information Specialist establishes and fosters a healthy working relationship between large physician practices, IPAs and the organization. For the right candidate, this role has the potential to transition into a full-time opportunity. Apply today! Company Description Managed Care Organization Job Description The Quality Information Specialist (RN): Advises and educates large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters) Delivers provider specific metrics and coach providers on gap closing opportunities Identifies specific practice needs where the organization can provide support Develops, enhances and maintains provider clinical relationship across product lines Leads and/or supports collaborative business partnerships, elicit client understanding and insight to advise and make recommendations Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Provides resources and educational opportunities to provider and staff Captures concerns and issues in action plans as agreed upon by provider Required Skills Bachelor's Degree in Nursing or equivalent work experience of 3+ years directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement; or 2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff 1+ year of experience in Managed Care experience One of the following: LPN, RN, APRN Proficient in Microsoft Office programs Proficient in Generic Healthcare Management Systems Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions Demonstrated interpersonal/verbal communication skills Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Ability to multitask Desired Skills Master's Degree in Nursing One fo the following: HCQM, CHP, CPHQ

Job Description: Quality Specialist (RN) Quality Specialist (RN) Location: Northern New Jersey Salary: $90,000-$105,000 Experience: 3.0 year(s) Job Type: Full-Time Job ID: J135177       About the Opportunity A widely recognized health system located in Northern New Jersey is actively seeking a self-motivated and dynamic Registered Nurse (RN) for a promising opportunity on their staff as a Quality Specialist. In this role, the Quality Specialist will identify opportunities for improvement within the healthcare system. Apply today! Company Description Health System Job Description The Quality Specialist (RN): Collaborates with with Risk and patient safety programs Helps develop materials regarding regulatory compliance and patient safety Communicates information throughout the system, educates on proper procedures Provides consultative services for staff toward meeting standards of accreditation Required Skills Active New Jersey State Registered Nurse license Strong medical skills and knowledge BSN 3+ years of previous experience in quality or Performance Improvement Strong attention to detail Ability to multitask

Job Description: Quality Information Specialist Quality Information Specialist Location: Fort Myers, FL Salary:  Experience: 2.0 year(s) Job Type: Temporary / Consulting Job ID: U1014671       About the Opportunity An established managed care organization located in Fort Myers, FL is actively seeking a compassionate and driven healthcare professional for a promising opportunity on their staff as a Quality Information Specialist. In this role, the Quality Information Specialist establishes and fosters a healthy working relationship between large physician practices, IPAs and the organization. For the right candidate, this role has the potential to transition into a full-time opportunity. Apply today! Company Description Managed Care Organization Job Description The Quality Information Specialist (RN): Advises and educates large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters) Delivers provider specific metrics and coach providers on gap closing opportunities Identifies specific practice needs where the organization can provide support Develops, enhances and maintains provider clinical relationship across product lines Leads and/or supports collaborative business partnerships, elicit client understanding and insight to advise and make recommendations Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Provides resources and educational opportunities to provider and staff Captures concerns and issues in action plans as agreed upon by provider Required Skills Bachelor's Degree in Nursing or equivalent work experience of 3+ years directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement; or 2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff 1+ year of experience in Managed Care experience One of the following: LPN, RN, APRN Proficient in Microsoft Office programs Proficient in Generic Healthcare Management Systems Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions Demonstrated interpersonal/verbal communication skills Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Ability to multitask Desired Skills Master's Degree in Nursing One fo the following: HCQM, CHP, CPHQ

Job Description: Family Nurse Practitioner (FNP / APRN) Family Nurse Practitioner (FNP / APRN) Location: New Haven County, CT Salary: $90,000-$120,000 Experience: 1.0 year(s) Job Type: Full-Time Job ID: J137684       About the Opportunity A respected healthcare facility located in New Haven County, CT is actively seeking a compassionate and self-motivated Family Nurse Practitioner (FNP / APRN) for a promising opportunity on their staff. In this role, the Family Nurse Practitioner will provide primary care in outpatient offices. Apply today! Company Description Healthcare Facility Job Description The Family Nurse Practitioner (FNP / APRN) will: Order, perform and interpret diagnostic tests Create treatment plans Initiate appropriate specialty referrals Collaborate on improvement in care delivery and service with management and other physicians and staff Work with care team to close care gaps and improve quality measures Participate in Patient-Centered Medical Home (PCMH) and Accountable Care Organization (ACO) initiatives Work with practice management to ensure compliance with billing and coding requirements Provide on call coverage within the primary care group Required Skills MSN Graduation from accredited APRN or PA program Valid and unrestricted Connecticut FNP or APRN license Valid DEA registration and Controlled Substance Certificate 1+ year of experience in primary care Strong clinical skills and knowledge Patient-oriented

Job Description: Psychiatry Nurse Practitioner (NP) Psychiatry Nurse Practitioner (NP) Location: Stamford, CT Salary: $96,000-$121,000 Experience: 1.0 year(s) Job Type: Full-Time Job ID: J131062       About the Opportunity A medical facility in Connecticut is currently seeking a licensed Nurse Practitioner, with a strong Psychiatric background, for a promising position with their growing staff. In this role, the Psychiatry Nurse Practitioner (NP) will be responsible for providing professionally skilled psychiatric evaluation, treatment, and appropriate disposition of patients presenting with psychiatric symptomatology. Company Description Medical Facility Job Description The Psychiatry Nurse Practitioner (NP): Performs medical and psychiatric history taking, utilizes appropriate diagnostic techniques and prepares a comprehensive psychiatric assessment report Completes accurate and appropriate orders; develops treatment plans in conjunction with physician; documents all aspects of care according to standards Recognizes and evaluates patients who require immediate attention of a physician, and when necessary, initiates emergency psychiatric treatments Provides after hours psychiatry coverage at the hospital when requested to do so by Department Chair or designee Provides necessary education, instruction, and counseling as indicated after assessing the learning needs of the patient and family Conducts Managed Care pre-certifications for patients requiring admission to inpatient psychiatric care Keeps track of all consultations done by the Consultation-Liaison team and makes monthly report to Department Chair Performs history and physical examination on patients admitted to inpatient psychiatry unit Participates in departmental and hospital wide quality improvement and patient safety projects as requested by Department Chair or designee Performs Psychiatric care of patients on the Inpatient Psychiatry unit as well as in Psychiatry Consultation Liaison Service Participates in departmental and hospital wide committees when asked to do so by Department Chair or designee Prepares and submits accurate professional bills to hospital billing agency Required Skills 1+ year of related experience BSN / MSN CT Nurse Practitioner (NP) license Certification in specialty area of Psychiatry DEA and Controlled Substance Registration Patient oriented Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized $ Desired Skills 1+ year of Psychiatry work experience

Job Description: Quality Review Specialist (RN) Quality Review Specialist (RN) Location: Brooklyn, NY Salary: $85,000-$100,000 Experience: 2.0 year(s) Job Type: Full-Time Job ID: J134745       About the Opportunity A medical facility in New York City is currently seeking a licensed Registered Nurse (RN) for a promising Quality Review Specialist position with their growing staff. In this role, the Quality Review Specialist (RN) will be responsible for quality assurance, accuracy and overall integrity of the care management records and documentation completed by Care Management staff. Apply today! Company Description Medical Facility Job Description The Quality Review Specialist (RN): Ensures compliance with NYS DOH and CMS regulations through development of auditing tools, specifically validating all data collected Analyzes collected audit data, identify trends for staff re-training and implementing corrective action plans in collaboration with Clinical management staff Provides support to Directors, Managers and Supervisors to insure that all documentation and reporting requirements are prepared and maintained in a professional and well-coordinated manner Reviews, collects and prepares evidence packets for all scheduled fairs Required Skills 2+ years of Care Management experience Graduate from an accredited School of Nursing NYS Registered Nurse (RN) license Previous experience with Performance / Quality Improvement and Risk Management Computer savvy Microsoft Office/Suite proficient (Excel, Word, etc.) Knowledge of Medicare and Medicaid regulations Working knowledge of Audit techniques and methodologies Working knowledge of State and Federal regulations Solid analytical and critical thinking skills Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills BSN or Bachelor's Degree in a related field Microsoft PowerPoint proficient

Job Description: Clinical Documentation Specialist (RN) Clinical Documentation Specialist (RN) Location: Hartford County, CT Salary: $70,000-$95,000 Experience: 4.0 year(s) Job Type: Full-Time Job ID: J134160       About the Opportunity A healthcare facility in Connecticut is currently seeking a licensed Registered Nurse (RN) to join their staff as a Clinical Documentation Specialist. In this role, the Clinical Documentation Specialist (RN) will be responsible for the clinically-based concurrent review of inpatient medical records to evaluate the utilization and documentation of acute care services supporting hospital’s quality care, health information management, charge capture and revenue improvement. Company Description Healthcare Facility Job Description The Clinical Documentation Specialist (RN) will be responsible for: Improving overall quality and completeness of clinical documentation to accurately reflect patient severity of illness and risk of mortality through extensive interaction with physician, case management, nursing staff, other patient caregivers Ensuring complete, accurate and timely documentation for clinical communication and charge capture based on medical record documentation Accurate establishment of clinical documentation and charge capture, researching and resolving charge system problems and analysis of current systems for purposes of identifying system improvements Documenting system performance to ensure accuracy, compliance and to improve revenue Working as part of multi-disciplinary team that includes clinical leadership and staff, charge entry, medical records, coding, billing, information systems, quality, and compliance Training staff responsible for charge capture, medical record documentation and collaborates with other departments in the development of improved systems Supporting and enhances the compliance effort of the Hospital and the System by adhering to all regulatory, departmental and organizational guidelines for charging and specific government regulations Required Skills 3+ years of Acute Care Hospital experience BSN CT Registered Nurse (RN) license Current Basic Life Support (BLS) certification Solid assessment and documentation skills Computer savvy Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills MSN Certified Coder

Job Description: Urgent Care Nurse Practitioner / Physician Assistant (NP / PA) Urgent Care Nurse Practitioner / Physician Assistant (NP / PA) Location: Danbury, CT Salary: $80,000-$120,000 Experience: 1.0 year(s) Job Type: Full-Time Job ID: J134782       About the Opportunity A premier primary health care system located in Danbury, CT is actively seeking a driven and patient-oriented Nurse Practitioner or Physician Assistant (NP / PA) for a promising opportunity on their Urgent Care staff. In this role, the Urgent Care NP / PA will assess and treat common acute and episodic illness of adults and children. Additionally, the NP / PA will provide setting-appropriate services as appropriate. Company Description Primary Health Care System Job Description The Urgent Care Nurse Practitioner / Physician Assistant (NP / PA) will: Perform appropriate diagnostic waived testing as required Arrange for follow-up care with PCP Provide problem-specific education to individual and family members as appropriate Utilize evidence based standards in formulating treatment plan Communicate rationale for decision making with patients Document all findings Participate in the organization’s quality improvement program Required Skills Graduate of an accredited Master of Science in Nursing program or Physician Assistant Master's program Licensed as either a Family Nurse Practitioner or Physician Assistant 1+ year of Urgent Care experience Strong clinical skills and knowledge Patient-oriented Desired Skills Bilingual, English and Spanish

Job Description: Family Nurse Practitioner (FNP) Family Nurse Practitioner (FNP) Location: New Britain, CT Salary: $90,000-$110,000 Experience: 2.0 year(s) Job Type: Full-Time Job ID: J132623       About the Opportunity A healthcare facility in Connecticut is actively seeking a licensed Family Nurse Practitioner (FNP) for a promising position with their growing staff. In this role, the Family Nurse Practitioner (FNP) will be responsible for providing the continuity of car to clients by established an ongoing primary care / client relationships with individual and their families. This is a great opportunity for a diligent and dedicated Family Nurse Practitioner (FNP) to gain valuable work experience and further their career at an established facility in Hartford County. Apply today! Company Description Healthcare Organization Job Description The Family Nurse Practitioner (FNP) will be responsible for Practicing and contributing to the development of evidence-based medicine Participating in quality improvement initiatives and educational enrichment, such as Grand Rounds Collaborate with a team of Medical Assistants (MAs) and Registered Nurses (RNs) Utilizing a Meaningful Use (MU) certified electronic health platform to document and manage patient information and communicate with other team members Assessing, diagnosing and managing acute and chronic health problems using the models of planned care and the chronic care model Performing comprehensive health histories and physical assessments developing appropriate treatment plans Required Skills 2+ years of experience eating Acute and Chronic patient issues Master's Degree in Nursing Active CT Family Nurse Practitioner (FNP) license Previous experience working in an Emergency Room, Primary Care and/or Urgent Care setting Solid assessment, clinical, and documentation skills Patient-oriented Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills Bilingual (English and Spanish or Polish)

Job Description: Utilization Management Compliance Specialist (RN) Utilization Management Compliance Specialist (RN) Location: New York, NY Salary:  Experience: 5.0 year(s) Job Type: Temporary / Consulting Job ID: J136922       About the Opportunity A widely recognized healthcare facility located in New York City is actively seeking a self-motivated and diligent Registered Nurse (RN) for a promising opportunity on their staff as a Utilization Management Compliance Specialist. In this role, the Utilization Management Compliance Specialist implements compliance programs, policies and procedures designed to ensure compliance with all applicable federal laws, regulations and delegation requirements. Apply today! Company Description Healthcare Facility Job Description The Utilization Management Compliance Specialist (RN): Analyzes delegation audit results and makes recommendations for improvement Identifies and communicates with appropriate departments, teams, and key leadership on internal audit results and/ or deficiencies Prepares audit files for submission as required Participates in delegation audits, supplying information as needed Performs tasks related to external audits from contracted health plans/employer groups as well as pre-delegation review with potential health plans as required Coordinates with delegated partners to ensure adherence to all regulations, contractual agreements, NCQA, and URAC guidelines Follows up on corrective action plans ensuring timely closure Prepares adverse determination notices in compliance with regulatory requirements Required Skills Graduate of an accredited school of nursing with a minimum of an ASN Active Registered Nurse license 5+ years of total experience 2+ years of utilization management experience Working knowledge and understanding of basic utilization management and quality improvement concepts Polished and professional demeanor Ability to multitask Excellent communication skills   Desired Skills BSN Experience in assisted reproductive technology including general infertility, IVF or infertility care management, or women’s health

Job Description: Quality Practice Advisor Quality Practice Advisor Location: Jacksonville, FL Salary: $60,000-$85,000 Experience: 2.0 year(s) Job Type: Full-Time Job ID: J137523       About the Opportunity An established managed care company in Jacksonville, FL is actively seeking a self-motivated and dynamic individual for a promising opportunity on their staff as a Quality Practice Advisor. In this role, the Quality Practice Advisor establishes and fosters a healthy working relationship between large physician practices, IPAs and the company. Apply today! Company Description Managed Care Company Job Description The Quality Practice Advisor: Advises and educates large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters) Delivers provider specific metrics and coach providers on gap closing opportunities Identifies specific practice needs where the company can provide support Develops, enhances and maintains provider clinical relationship across product lines Defines gaps in the company's service relationship with providers and facilitate resolution Leads and/or supports collaborative business partnerships Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Required Skills Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field One of the following: Certified Coding Specialist (CCS), LPN, LCSW, LMHC, LMSW, LMFT,  LVN, RN, NP, record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff 3+ years of directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement 1+ year of experience in Managed Care  3 + years of directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement 2+ years of experience in directly related HEDIS medical Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Desired Skills Master's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field

Job Description: Quality Practice Advisor Quality Practice Advisor Location: Trenton, NJ Salary:  Experience: 3. year(s) Job Type: Temporary / Consulting Job ID: U1011207       About the Opportunity A healthcare company in New Jersey is actively seeking a licensed / certified professional to join their growing staff as a Quality Practice Advisor. In this role, the Quality Practice Advisor will be responsible for educating providers and supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Apply today! Company Description Healthcare Company Job Description The Quality Practice Advisor will be responsible for: Advising and educating large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements Collecting, summarizing and trending provider performance data to identify and strategize opportunities for provider improvement Delivering provider specific metrics and coach providers on gap closing opportunities Identifying specific practice needs where the company can provide support Developing, enhancing and maintaining provider clinical relationship across product lines Leading and/or supporting collaborative business partnerships, elicit client understanding and insight to advise and make recommendations Partnering with Physicians / Physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Providing resources and educational opportunities to provider and staff Documenting action plans and details of visits and outcomes and reporting critical incidents and information regarding quality of care issues Communicating with external data sources as needed to gather data necessary to measure identified outcomes Required Skills 3+ years of directly-related experience in HEDIS record collection with analytical review / evaluation and/or Quality Improvement; 1+ year of Managed Care experience Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field One of the following licenses: Certified Coding Specialist (CCS); Licensed Practical Nurse (LPN); Licensed Clinical Social Worker (LCSW); Licensed Mental Health Counselor (LMHC); Licensed Master Social Work (LMSW); Licensed Marital and Family Therapist (LMFT); Licensed Vocational Nurse (LVN); Licensed Registered Nurse (RN); and/or, Acute Care Nurse Practitioner (APRN) (ACNP-BC) Solid analytical skills Computer savvy Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills Master's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field One of the following licenses: Health Care Quality and Management (HCQM); Certified Healthcare Professional (CHP); and, Certified Professional in Healthcare Quality (CPHQ)

Job Description: Quality Practice Advisor (HEDIS) Quality Practice Advisor (HEDIS) Location: Newark, NJ Salary:  Experience: 2.0 year(s) Job Type: Temporary / Consulting Job ID: U1011592       About the Opportunity A recognized healthcare organization located in Newark is actively seeking a diligent and driven healthcare professional, with a strong HEDIS background, for a promising opportunity on their staff as a Quality Practice Advisor. In this role, the Quality Practice Advisor establishes and fosters a healthy working relationship between large physician practices, IPAs and the organization. Company Description Healthcare Organization Job Description The Quality Practice Advisor: Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters) Delivers provider specific metrics and coach providers on gap closing opportunities Identifies specific practice needs where the organization can provide support Develops, enhances and maintains provider clinical relationship across product lines Leads and/or supports collaborative business partnerships Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education. Provides resources and educational opportunities to provider and staff Captures concerns and issues in action plans as agreed upon by provider   Required Skills BSN or equivalent work experience of 3+ years directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement 2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff 1+ year of experience in Managed Care experience One of the following: LPN, RN, APRN Proficient ion Healthcare Management Systems Intermediate knowledge of Microsoft Office Suite Demonstrated analytical skills (Intermediate) Demonstrated customer service skills (Intermediate) Ability to analyze information and covert related activities into a comprehensive work plan Desired Skills MSN HCQM, CHP, or CPHQ

Job Description: Quality Practice Advisor Quality Practice Advisor Location: Jacksonville, FL Salary:  Experience: 2.0 year(s) Job Type: Temporary / Consulting Job ID: U1011417       About the Opportunity A widely recognized managed care organization headquartered in Jacksonville, FL is actively seeking a self-motivated and compassionate healthcare professional fro a promising opportunity on their staff as a Quality Practice Advisor. In this role, the Quality Practice Advisor educates providers and supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Company Description Managed Care Organization Job Description The Quality Practice Advisor (RN): Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations Delivers provider specific metrics and coach providers on gap closing opportunities Identifies specific practice needs where the organization can provide support Develops, enhances and maintains provider clinical relationship across product lines Defines gaps in the organization's service relationship with providers and facilitate resolution Leads and/or supports collaborative business partnerships Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Provides resources and educational opportunities to provider and staff Captures concerns and issues in action plans as agreed upon by provider Required Skills Bachelor's Degree in Nursing or equivalent work experience of 3 + years directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement 2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff 1+ year of experience in Managed Care experience One of the following licenses:  Licensed Practical Nurse, Registered Nurse (RN), Acute Care Nurse Practitioner (APRN) Demonstrated interpersonal/verbal communication skills Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Ability to implement process improvements Knowledge of healthcare delivery Proficient in Microsoft Office programs and Healthcare Management Systems Desired Skills Master's Degree in Nursing

Job Description: Quality Practice Advisor (RN) Quality Practice Advisor (RN) Location: Tampa, FL Salary:  Experience: 3.0 year(s) Job Type: Temporary / Consulting Job ID: U1011418       About the Opportunity A Florida-based healthcare company is currently seeking a licensed Registered Nurse (RN) to join their staff as a Quality Practice Advisor. In this role, the Quality Practice Advisor (RN) will be responsible for strategizing with providers at their medical offices to close care gaps and provide guidance on quality measures, educating providers, etc. Apply today! Company Description Healthcare Company Job Description The Quality Practice Advisor (RN) will be responsible for: Advising and educating large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements Collecting, summarizing and trending provider performance data to identify and strategize opportunities for provider improvement Identifying specific practice needs where the company can provide support Developing, enhancing and maintaining provider clinical relationship across product lines Leading and/or supporting collaborative business partnerships, elicit client understanding and insight to advise and make recommendations Partnering with Physicians / Physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Providing communication, such as: newsletter articles; member education; outreach interventions; and, provider education Supporting quality improvement HEDIS and program studies as needed; requesting records from providers; maintaining databases; and, researching to identify members' provider encounter history Required Skills 3+ years of directly related HEDIS record collection experience; 2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience; 1+ year of Managed Care experience Bachelor's Degree in Nursing FL Registered Nurse (RN), Licensed Practical Nurse (LPN), and/or Acute Care Nurse Practitioner (APRN) license Knowledge of Medical terminology and/or experience with CPT and ICD-9 coding (Intermediate) Microsoft Office/Suite proficient (Excel, PowerPoint, Outlook, Word, etc.) Knowledge of Healthcare delivery (Intermediate) Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills Master's Degree in Nursing Active license in: Health Care Quality and Management (HCQM); Certified Healthcare Professional (CHP); and, Certified Professional in Healthcare Quality (CPHQ)

Job Description: Bilingual Transitions Assessment Nurse (RN) - Russian Bilingual Transitions Assessment Nurse (RN) - Russian Location: Brooklyn, NY Salary: $80,000-$90,000 Experience: 2.0 year(s) Job Type: Full-Time Job ID: J135544       About the Opportunity A nonprofit healthcare agency in New York City is currently seeking a Russian-speaking, licensed Registered Nurse (RN) for a promising Transitions Assessment Nurse position with their growing Transition Team. In this role, the Bilingual Transitions Assessment Nurse (RN) will be responsible for comprehensively assessing and evaluating the clinical needs of members after a facility discharge. This is a great opportunity for a diligent and highly dedicated Bilingual Transitions Assessment Nurse (RN) to gain valuable work experience and further their career at the agency's facility in Brooklyn. Apply today! Company Description Nonprofit Healthcare Agency Job Description The Bilingual Transitions Assessment Nurse (RN) will be responsible for: Performing home or facility visits to assess the member / caregiver’s ability, during or following an acute episode, to perform key function, such as: medication self-management/reconciliation; identification of symptoms (red flags); and, attending a follow-up visit with the primary care provider or specialist Performing and documenting their assessments, including UAS, and other assessments as indicated on assigned members Assessing member’s care goals, preferences, and need for services; facilitating and advocating for members with their primary care provider during the care transition(s) Assisting the member and family / caregiver in understanding the primary care provider’s treatment plans and instructions Collaborating with the member’s primary care provider to clarify, adjust, or order post-discharge medications and services as indicated Modeling and facilitating new behaviors and communication skills for members and families to improve self-management skills and the ability to successfully respond to common problems that arise during care transitions Implementing preventive and health maintenance education to members and caregivers as indicated Required Skills 2+ years of Hospital experience; 1+ year of Home Care, Community-based, or Public Health experience BSN NYS Registered Nurse (RN) license Bilingual (English and Russian) Solid documented assessment and care planning skills Patient oriented Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Able to multitask efficiently and effectively Desired Skills Uniformed Assessment System (UAS) experience

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Performance improvement specialist jobs are essential to ensuring medical facilities consistently provide quality care. In these positions, healthcare professionals gather and analyze data looking for opportunities to improve day-to-day operations.  

By studying clinical charts, conducting audits and evaluating other healthcare data, performance improvement specialists identify areas in which the facility can improve. They are responsible for developing and implementing performance improvement activities which train staff members to deliver better care. They are also in charge of planning, developing and delivering staff in-services to further educate clinical staff.

To qualify for performance improvement specialist jobs, candidates usually need to be an RN with experience. BSN or MSNs are preferred. A master’s degree in public health or MBA may also qualify an individual for performance improvement specialist jobs.

Looking for performance improvement specialist positions? Find them here at ADVANCE Healthcare Jobs. Our dashboard allows you to save jobs that interest you, apply to jobs in seconds, track the status of your application, see how many employers have viewed your profile and much more. Get started today!