Clinical Quality Improvement Nurse

Applies process improvement methods to daily work to comply with National Committee for Quality Assurance (NCQA), accreditation standards and the Centers for Medicare & Medicaid Services (CMS) regulations for quality. Performs medical record reviews to derive analyses and supporting documentation to enhance NCQA, Healthcare Effectiveness Data and Information Set (HEDIS) and Medicare Star ratings as well as data analysis to recommend and implement process improvement methods and reporting.

Supports and collaborates with provider groups to promote quality and oversight of quality vendors.