QI Coordinator

Centene Corporation is a leading multi-line healthcare enterprise that provides managed-care programs and related services to individuals receiving benefits under Medicaid, including Supplemental Security Income (SSI) and the State Children’s Health Insurance Program (SCHIP).Perform duties to conduct credentialing reviews, medical record audits and data collection for various quality improvement studies and activities, and respond to complaints and follow up review of risk management and sentinel health event issues.Bachelor’s degree in nursing preferred. 3 – 5 years clinical nursing experience in an acute care setting particularly in medical/surgical, pediatrics, obstetrics or home health. 1 – 3 years experience in quality function. Work in managed care environment and prefer experience in HMO environment.Thorough knowledge of a specialized or technical field such as clinical nursing knowledge in medical/surgery, obstetrics, or pediatrics, plus the application of basic managed care theory. Ability to use computer skills for the management of medical information and reporting; good communication skills; pleasant, professional interpersonal skills; problem-solving orientation and skills; good analytical and mathematical skills, strong team player; self-starter, initiate assignments with minimal supervision Licenses/Certifications: RN, LPN or LVN. Current state nursing license and driver’s license. CPHQ preferred.4 or more years of expericence,Amisys,Associate's Degree,Microsoft Excel,Microsoft Outlook,Microsoft Word,Required Certifications/Licenses