Quality Improvement LVN in san bernardino, California at LSMA Management Inc

JOB SUMMARY

The Quality Improvement Nurse supports the Directory of Quality Improvement in implementing and maintaining the Quality Improvement (QI) Program, including Pay for Performance (P4P) initiatives, regulatory reporting, and clinical quality activities. The QI Nurse ensures compliance with NCQA, CMS, state, federal, and health plan standards and collaborates with internal departments, physician offices, and external partners to achieve departmental and organizational quality goals.

MINIMUM & PREFERRED QUALIFICATIONS

Education/Training

Minimum: High School diploma or equivalent required. Graduate of an accredited Vocational Nursing Program.

Preferred: Bachelor’s degree in Nursing or healthcare-related field.

Experience

Minimum: 3+ years of clinical experience and at least 1 year of Quality Management or QI experience.

Preferred: 1+ years of managed healthcare experience.

Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.

Certification(s)

Valid and unrestricted state LVN license.

Quality-related certifications (e.g. CPHQ) desirable but not required.

Skills, Knowledge & Abilities

· Strong knowledge of NCQA, CMS, and health plan quality standards.

· Proficiency in Microsoft Word and Excel.

· Strong verbal and written communication skills.

· Ability to analyze clinical and quality data.

· Ability to work independently and manage multiple deadlines.

· Strong interpersonal and customer service skills.

· Familiarity with HIPAA and confidentiality standards.

PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS

The physical, mental, and environmental demands described here are representative of those required to successfully perform the essential functions of this job. The role is primarily sedentary, with sitting making up most of the workday and occasional standing, walking, bending, stooping, and reaching. It requires frequent hand and grip use, regular driving and travel, and the ability to lift up to 20 pounds. Strong analytical and organizational abilities, sound judgment, and the capacity to manage multiple priorities, deadlines, and confidential information are essential. Work occurs in both office and field environments, including provider offices and audit sites, with exposure to typical clinical office settings.

PAY RANGE

$35.00 - $40.00 / hourly