At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

This position is responsible for facilitating BCBSIL clinical quality improvement projects and evaluation of PCP/MG/IPA and HEDIS/QRS compliance with BCBSIL clinical practice guidelines; consults with MG/IPAs, physicians, providers, members, and other resources to assess, plan, facilitate implement, coordinate, monitor and evaluate options and services required to meet clinical quality improvement project objectives; serves as preceptor for less experienced staff. Job Requirements * Registered Nurse (RN), Physician's Assistant OR MSW (Master of Social Work)/LCSW (Licensed Clinical Social Worker) or other BH licensure with current, unrestricted license to practice in the state of operations * Medical specialty certification (Certified Professional in Healthcare Quality (CPHQ) or Diabetic Education) OR Bachelor Degree in medical field such as Nursing, Health Care Administration. * 3 years clinical practice experience. * 2 years’ experience in health insurance or managed care. * 2 years quality improvement and/or project management experience. * Experience conducting presentations for member and/or provider training. * Current unrestricted driver’s license. * Ability to travel including overnight stays. * Verbal and written communications skills. * Data analysis experience. * PC proficiency to include Word, Excel, and PowerPoint. Preferred Requirements Experience with HEDIS/QRS medical record review validation and/or experience with NCQA HEDIS requirements, such as Inovalon software or other HEDIS approved software used in the industry. #LI-CH1 #LI-Flex INJLF

Compensation: $61,500.00 - $136,100.00

Exact compensation may vary based on skills, experience, and location

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

To learn more about available benefits, please click https://careers.hcsc.com/totalrewards