RN Job

Quality Management Nurse Specialist RN II (ALD)

Full Time Regular
Req #8161
Los Angeles, 90017

The Quality Management Nurse Specialist RN II is responsible for overseeing the clinical aspects for quality improvement projects/activities, which may include but are not limited to the clinical review process for potential quality of care and service issues, regulatory compliance with CMS, DMHC, DHCS, and NCQA. 

This position is responsible for ensuring program activities are completed in a high quality and timely manner and ensuring compliance with all regulatory guidelines such as Medicaid (Medi-Cal), Medicare, and the Health Exchange, as well as National Committee for Quality Assurance (NCQA) Accreditation.

Qualifications
  • Must have excellent analytical skills, working knowledge of statistics and reporting.  
  • Must be detail-oriented and effective critical thinking skills.  
  • Proficient in Microsoft Office (Word, Excel). 
  • Strong interpersonal skills and high level of professionalism. 
  • Ability to work independently and within a team environment. 
  • Preferred:Knowledge in the community standards of practice, including clinical guidelines.
  • Licenses/Certifications Required
  • Registered Nurse (RN) - Active, current and unrestricted California License
  • Licenses/Certifications Preferred
  • Certified Professional in Healthcare Quality (CPHQ)
About the Hospital

As the nation's largest publicly-operated health plan, we have a great responsibility to the communities we serve, and our employees play an essential role in ensuring we meet those needs.

Why Join Us?
Opportunity. Amazing co-workers. A supportive management team. Great compensation and benefits. Camaraderie and a true sense of mission. If you want a career that truly contributes to the good of all, join us as we work towards a healthier L.A.

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