Clinical Quality Management Analyst - RN (Remote)
Company: Highmark Inc. | Location: Remote, United States | Salary: $62,700 to $97,200 per year | Employment: Full-time | License: Multiple | State licensure: Alabama|Alaska|Arizona|Arkansas|California|Colorado|Connecticut|Delaware|District of Columbia|Florida|Georgia|Hawaii|Idaho|Illinois|Indiana|Iowa|Kansas|Kentucky|Louisiana|Maine|Maryland|Massachusetts
Company : Highmark Inc. Job Description : JOB SUMMARY This job works with appropriate departments in the areas of compliance, process improvement, medical record review and coding, and member and provider satisfaction for all product lines. Recommends and implements process improvements related to the potential of quality medical care and service to members and to improve documentation of these services for appropriate ICD 10-CM coding. Serves as a resource and educator regarding provider and office staff medical record documentation, federal and state standards including CMS and NCQA standards and continuous quality improvement principles. Perform special studies per audits, conducting office site visits and medical records reviews, ensuring improvement in performance for various initiati