Clinical Improvement Specialist Job at CenCal Health, Santa Barbara, CA

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  • CenCal Health
  • Santa Barbara, CA

Job Description

Company Description

CenCal Health is a publicly-funded managed care organization that provides health care coverage for residents in Santa Barbara and San Luis Obispo counties. We are currently seeking a Claims Customer Service Supervisor in our Santa Barbara office location.

Job Description
  • We're looking for a RN that likes to make visits to local providers/clinics to upgrade our quality of care for our members. Need to have 2+ years experience in healthcare field, outpatient care a plus. Are you good at understanding clinical issues and medical diagnosis? Performed chart audits? We've got an opportunity for you!

Qualifications

This role has a requirement of being in office 1 day per month in Santa Barbara
  • Strong team-oriented ability to
    connect with quality improvement staff, and establish and maintain positive
    professional working relationships, both within and outside CenCal Health
  • Knowledge of quality improvement
    theory, strategy, and practical methods to achieve rapid-cycle improvement;
  • Ability to perform effectively under
    pressure and maintain focus on daily responsibilities for long-term projects;
  • Ability to establish and nurture
    positive professional working relationships with CenCal Health customers;
  • Ability to evaluate data,
    establish facts and draw valid conclusions;
  • Effective oral and written
    communication skills;
  • Ability to perform HEDIS medical

Education and Experience
  • Bachelor's Degree in ajob-related field
  • 2 years' experience in a managed care quality management setting (or combination of academic, professional or work experience that demonstrates ability to perform the duties of the position.
  • Current and unrestricted Registered Nurse (RN) license to practice in California
DESIRED:
  • A graduate degree in a
    healthcare- or management-related discipline is preferred (e.g., MBA, MPH)
  • Certified Professional in
    Healthcare Quality (CPHQ) or similar certification
  • HEDIS medical record data abstraction

An emphasis in Medicaid/Medi-Cal managed care

Salary Range: $78,562 - $121,771

Additional Information

To view our current job openings, please visit our website at

Job Tags

Work experience placement, Local area,

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