Located in Bethesda, MD, Managed Care Advisors (MCA) is an innovative company with a unique set of services specific to Specialized Health Program Management, Federal Workers’ Compensation, Employee Benefits, Disability Management and Absence Management. MCA has an immediate opening for a bright, caring, and motivated telephonic Quality Improvement (QI) Specialist Nurse. This is a nationwide opportunity.
Managed Care Advisors:
- Provides an exciting and fast-paced work environment
- Celebrates our individual and team successes together
- Supports a team oriented work atmosphere
- Provides telephonic work opportunities
The Quality Improvement (QI) Specialist is a Registered Nurse responsible for supporting the quality improvement activities related to a specialty Health and Pharmacy Program. The QI Specialist supports these activities by coordinating and facilitating all quality committee functions related to the Health Program, performing audits, assisting with performance improvement plans and reporting on quality improvement activity outcomes. The QI Specialist collaborates with and supports the account management and clinical teams by monitoring program goals and objectives and preparing the annual contractually required quality assurance reports.
- Serves as knowledgeable expert for QA/QI activities
- Provides input to clinical management team regarding analysis, updates, and recommendations for modifications of procedures and processes to continually improve clinical operations and protocols
- Coordinates training and monitoring regarding deployment of new clinical protocols related to the program
- Assists in identification of health program deficits and coordinates team training and monitoring of corrective actions
- Deploys and oversees performance improvement activities
- Bachelor’s or Master’s Degree preferred in Healthcare, Nursing, Health Administration or related field
- Registered Nurse, licensed in any state, with national certification in relevant field
- At least 10 years’ nursing experience
- 2 years’ managed care experience preferred
- 2 years’ Pharmacy Benefit Management related experience preferred
- Experience in compliance, quality improvement, audit and staff education
- Intermediate working knowledge of Microsoft Excel, PowerPoint and Word. Working knowledge of Access is a plus
- Analytical skills in interpreting data
- Strong communication skills (verbal and written)
- Attention to detail and timetables
- Commitment to completing tasks
- Ability to work with a team
- Established Home office with internet router in the office
- Cable or Fiber Optic internet connection
- United States Citizenship
- Upon hire, a federal security clearance will be required
- Ability to pass a preliminary credit and background check
The Company provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age, disability, genetics or protected Veteran status. We participate in the United States Federal Government E-Verify program to confirm the employment authorization of each employee upon hire. A successful candidate will be required to undergo a criminal background check, and obtain and maintain confidential-level security clearance upon hire.
For immediate consideration please submit your cover letter and resume via the application below.
No Phone Calls Please.