Clinical Improvement Specialist

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🏄 California – Remote

🏄 California – Remote

💵 $78.6k - $121.8k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

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CenCal Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1983

⚕️ Healthcare Insurance

Healthcare Insurance

CenCal Health is a local health plan that provides Medi‑Cal and related managed-care services to residents, offering member-centered coverage, care coordination, and community health programs. It administers Medi‑Cal benefits, a dual-eligible product (CenCal CareConnect), pharmacy and provider network services, nurse advice and after-hours care, case management and CalAIM-enhanced care management, and resources for members and providers. CenCal Health also engages in community outreach, reporting, and provider support to improve population health in its service area.

📋 Description

• Make visits to local providers/clinics to upgrade quality of care for members • Perform chart audits • Connect with quality improvement staff, establishing and maintaining professional working relationships • Evaluate data, establish facts, and draw valid conclusions

🎯 Requirements

• 2+ years experience in healthcare field • Current and unrestricted Registered Nurse (RN) license to practice in California • Knowledge of quality improvement theory, strategy, and practical methods to achieve rapid-cycle improvement • Effective oral and written communication skills • Ability to perform HEDIS medical record data abstraction • Bachelor’s Degree in a job-related field • A graduate degree in a healthcare- or management-related discipline is preferred (e.g., MBA, MPH)