Quality of Care Coordinator
Company: Oklahoma Complete Health
Posted on: November 19, 2023
You could be the one who changes everything for our 28 million
members as a clinical professional on our Medical Management/Health
Services team. Centene is a diversified, national organization
offering competitive benefits including a fresh perspective on
Must live in OklahomaOklahoma Complete Health, a Centene company,
is committed to providing quality healthcare solutions to transform
the health of Oklahomans.
At Oklahoma Complete Health, we are community advocates and
change-makers in search of an inclusive culture grounded by our
commitment to work-life balance, competitive compensation, and
continuous career development. Join us and be a part of a
collaborative, growing network of innovative thinkers delivering
solutions at the local level.Position Purpose: Review medical
records for potential Quality of Care (QOC) incidents, applying
clinical criteria to determine if a lack of care was present.
Utilize clinical knowledge to provide summary of findings and
severity level to physicians.
- Review medical records for quality of care incidents by
determining if the specified standards of care were met, and
assigning an initial severity level of lack of compliance/care
- Compile timeline and summary of incident, including the details
of the potential QOC for presentation to the medical director for a
final review; may also be involved in peer review committee actions
or next steps
- Maintains organizational and program policies and procedures;
ensures adherence to prescribed policies and procedures and
clinical protocols where appropriateEducation/Experience:
Associate's degree in Nursing required; Bachelor's degree in
Nursing preferred. 3+ years of experience in nursing or related
License/Certification: RN/LCSW required; CPHQ preferred
Our Comprehensive Benefits Package: Flexible work solutions
including remote options, hybrid work schedules and dress
flexibility, Competitive pay, Paid time off including holidays,
Health insurance coverage for you and your dependents, 401(k) and
stock purchase plans, Tuition reimbursement and best-in-class
training and development.
Centene is an equal opportunity employer that is committed to
diversity, and values the ways in which we are different. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability, veteran status, or
other characteristic protected by applicable law.
Keywords: Oklahoma Complete Health, Stillwater , Quality of Care Coordinator, Other , Stillwater, Oklahoma
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