Quality Management Specialist

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Luminare Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Luminare Health is a leading provider of self-funded health plan administration services with over 50 years of industry experience. The company specializes in offering flexible and innovative solutions for hospitals, health systems, and direct-to-employer initiatives, focusing on administration, cost management, and digital reporting tools. Luminare Health is dedicated to being a reliable partner in managing healthcare costs and supporting strategic growth for its clients. The company emphasizes a member-centered approach to healthcare while delivering significant savings through expert claim analysis and management of high-cost claims.

📋 Description

• Coordinate and implement Quality Improvement Activities and Initiatives for the Healthcare Management Division • Ensure compliance with applicable state, federal, and accreditation requirements • Manage licensure, regulatory standards, audits, and policy development • Coordinate quality improvement committees • Monitor performance metrics • Conduct audits and root cause analyses • Oversee accreditation and customer satisfaction processes • Serve as a regulatory and quality compliance resource across the organization • Collaborate cross-functionally to educate staff and promote compliant, high-quality healthcare management operations

🎯 Requirements

• Active unrestricted Registered Nurse license issued by a state or territory of the United States of America • Minimum of 3 years clinical experience • Ability to read and interpret documents, criteria, instructions, and policy and procedure manuals • Effective oral and written communication • Ability to write routine correspondence and reports • Ability to communicate with clients, physicians, providers, families in crisis, community agencies, co-workers, and senior management • Organization and prioritization skills for time-sensitive assignments • Ability to work independently with minimal supervision • Ability to work in a dynamic team-oriented environment • Confidentiality, flexibility, and willingness to learn new tasks • Ability to apply common-sense understanding to written, oral, or diagrammed instructions • Ability to deal with problems involving several concrete variables in standardized situations • Ability to evaluate problems, develop alternative solutions, and identify trends and patterns • Excellent interpersonal skills • Ability to perform multiple tasks simultaneously • Basic arithmetic and ability to compute rate, ratio, and percent • Remote employees must live within the continental United States, excluding Alaska, California, Hawaii, and New York • Sponsorship is not available

🏖️ Benefits

• Thoughtful development opportunities • Health and wellness benefits • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Other incentives • Annual incentive bonus plan