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Blue Cross and Blue Shield of Illinois, Montana, N Quality Management Specialist II in Albuquerque, New Mexico


This is a work-from-home role.

BASIC FUNCTION:This position is responsible for facilitating BCBSIL clinical quality improvement projects and evaluation of PCP/MG/IPA compliance with BCBSIL clinical practice guidelines; consults with MG/IPAs, physicians, providers, members, and other resources to assess, plan, facilitate implement, coordinate, monitor and evaluate options and services required to meet clinical quality improvement project objectives; serves as preceptor for less experienced staff.JOB REQUIREMENTS:* Registered Nurse (RN), LPN, LVN, Physicians Assistant OR MSW (Master of Social Work)/LCSW (Licensed Clinical Social Worker) or other BH licensure with current, unrestricted license to practice in the state of operations OR Respiratory Therapist with masters level or above degree* Medical specialty certification (Certified Professional in Healthcare Quality (CPHQ) or Diabetic Education) OR Bachelor Degree in medical field such as Nursing, Health Care Administration.* 3 years clinical practice experience.* 2 years experience in health insurance or managed care. * 2 years quality improvement and/or project management experience.* Experience conducting presentations for member and/or provider training.* Current unrestricted drivers license.* Ability to travel including overnight stays.* Verbal and written communications skills.* Data analysis experience.* PC proficiency to include Word, Excel, and PowerPoint.


Location: NM - Albuquerque, OK - Tulsa, TX - Richardson

Activation Date: Friday, January 14, 2022

Expiration Date: Saturday, January 22, 2022

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