Job Description

Quality Improvement Nurse PQI (RN)

We have an opportunity to join the Alliance as a Quality Improvement Nurse PQI (RN) in the QI and Population Health Department.

What You'll Be Responsible For

Reporting to the Clinical Safety Supervisor, this position:

• Develops, manages, and measures a comprehensive healthcare strategy in alignment with Department of Health Care Services (DHCS) standards of care and in collaboration with internal stakeholders and network providers to promote best evidence-based practices and improve member health outcomes
• Evaluates patient safety and quality issues and communicates findings to internal stakeholders, network providers, and community partners

What You'll Need To Be Successful

Desirable Qualifications

• Experience in process improvement, practice coaching, or health care quality improvement
• Experience performing PQI activities
• Working knowledge of managed care, the Medi-Cal program, and related policy
• Working knowledge of the methods of conducting and interpreting quantitative and qualitative analysis
• Some knowledge of NCQA HEDIS abstracting guidelines
• Some knowledge of CPT and ICD coding principles

Knowledge of:

• The principles and practices of clinical nursing
• Medical practice operations and healthcare delivery systems

Ability to:

• Participate in and support internal and external audits
• Identify issues, conduct research, gather and analyze information and data, reach logical and sound conclusions, and make recommendations for action
• Analyze information and data and prepare oral and written reports

Other Information

• We are in a hybrid work environment, and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed by location below. The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

Typical areas in Zone 1: Bay Area, Sacramento, Los Angeles area, San Diego area

Zone 1 (Monterey, San Benito and Santa Cruz): $91,055.76 - $145,704 USD

Typical areas in Zone 2: Fresno area, Bakersfield, Central Valley (with the exception of Sacramento), Eastern California, Eureka area

Zone 2 (Mariposa and Merced): $82,857.88 - $132,579.20 USD

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