LPN or RN Quality Clinical Coordinator - Memphis, TN
Location: Nashville
Description: Cigna is looking of LPN or RN Quality Clinical Coordinator - Memphis, TN right now, this position will be placed in Tennessee. Further informations about this position opportunity kindly see the descriptions. Job Description
Responsibilities
Coordinate and manage relationships with participating provider practices: Initiate and maintain ongoing productive and positive relationships with designated Point-of-Contact in each practice. Facilitate resolution of any discrepancies between claims and practice medical records. Communicate pertinent care and/or clinical information to the health plan for follow-up or inclusion in Company’s medical records. Maintain physical presence in participating. Serve as ongoing resource an! d support for P4Q or P4Q 2 Program needs in identified practic! es. Assist with communication between Point-of-Contact and practice staff/physicians. Participate in all operational meetings/calls as identified between practices and the health plan. Participate in regularly scheduled Practice Coordinator team conference calls.
Partner with in-office Point-of-Contact(s) to ensure practice success: Review and participate in audits of medical records. Coordinate real-time performance measure management across multiple practices that provide care for members in total by utilizing the designated Company system. Ensure that participating practices are driving improvement on P4Q or P4Q 2 Program performance measures. Review data for those members that are frequent users of healthcare resources to ensure they are receiving the proper coding and care. Suggest physician referrals to case management or behavioral health. Communicate real-time updates to identified Company team members. Develop and maintain a process to ensure that all memb! ers in participating practices receive the screenings and services needed within the given timeframe. Maintain detailed understanding (including clinical, coding, and operational knowledge) of all P4Q or P4Q 2 Program (HEDIS STAR) performance measures. May assist with data collection related to proper coding and documentation .
Requirements
Qualifications
Minimum Requirements: Unrestricted Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) in the State of Tennessee. At least one year related experience in a healthcare environment. Excellent written and oral communication skills; excellent problem solving skills; highly organized and proactive; ability to handle multiple tasks and set priorities; detailed oriented; works independently with minimum of supervision. Ability to travel to and work at participating practices.
Preferred Requirements: Current licensure as a Registered Nurse (RN), Nurse Practitioner, or! Physician’s Assistant in applicable state. Minimum of two years clin! ical practice experience in a providers’ office or hospital setting. At least five years HEDIS related experience and/or solid working knowledge of HEDIS measures.
Locations of Position: Memphis, Tennessee .
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If you were eligible to this position, please email us your resume, with salary requirements and a resume to Cigna.
If you interested on this position just click on the Apply button, you will be redirected to the official website
This position starts available on: Sun, 01 Dec 2013 15:23:47 GMT
Apply LPN or RN Quality Clinical Coordinator - Memphis, TN Here
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