Harrisburg, PA

Quality Management Manager - RN

Capital BlueCross seeks a Manager to oversee quality management  

including practitioner/facility provider assessments, focused reviews  

and HEDIS data collection; approve design/development/implementation  

of clinical and service quality improvement initiatives specific to  

plan wide population, Centers for Medicare and Medicaid, HEDIS, CAHPS  

and Quality Compass data and Pay for Improvement; and oversee the  

development, monitoring and annual evaluation of Quality Management  

Program Description, Quality Work Plan and Annual Work Plan Evaluation.

Active RN license must accompany 5+ years of clinical experience; 3+  

years of clinical study design/implementation experience;

a Bachelor’s Degree (Master’s in health care related field  

preferred); experience with NCQA/URAC accreditation requirements; and  

strong communication/PC/analytical/ presentation skills. Knowledge of  

state/ federal regulatory requirements, medical terminology, managed  

care programs/ principles, continuous quality improvement concepts,  

provider types with regard to scope of service capabilities, is  

necessary.

Excellent compensation/benefits offered.  

Send resume to: 

Email: human.resources@capbluecross.com

Capital BlueCross

Staffing

Harrisburg, PA  17177-2211

www.capbluecross.com  

EOE/AA