At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.
Come join us and be part of a purpose driven company who is invested in your future!Job Summary This Position Is Responsible For Conducting Audits As Well As Monitoring Ongoing Quality Improvement Activities Within The Medical Management Program; Analyzing Compliance With Departmental Policies, Regulatory And Accrediting Requirements, And Preparing Reports For Management Presentation To Internal Ancillary Departments And Committees; And Serving As A Resource To Internal Ancillary Departments On Quality And Utilization Issues And Contributing To Accreditation Survey Processes.
Responsibilities*Conduct audits as well as monitoring ongoing quality improvement activities within the Medical Management Program. *Analyze compliance with departmental policies, regulatory and accrediting requirements. *Prepare reports for management presentation to internal ancillary departments and committees. *Serve as resource to internal ancillary departments on quality and utilization issues. *Contribute to Accreditation Survey processes. Required Job Qualifications: *Registered Nurse (RN), Licensed Practical Nurse (LPN), OR Behavioral Health Professional with unrestricted license to practice in state of operations *3 years clinical experience, including 2 years utilization review or case management experience *Quality improvement experience *Working knowledge of the Medical Management Program and UM/CM policies and practices *Analytical skills *Verbal and written communication skills *PC experience utilizing Microsoft Office software Preferred Job Qualifications: *Bachelor Degree in Nursing or Health Administration or in the healthcare field *Certified Professional Health Care Quality (CPHQ Certification)
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!HCSC Employment Statement:
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.
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