California Licensed Quality Improvement Manager

Job Summary

A company is looking for a Quality Improvement Manager to oversee clinical staff and manage health plan grievances.

Key Responsibilities

• Monitor grievance database and ensure timely investigation of quality issues
• Facilitate team meetings and manage Peer Review Committee operations
• Implement quality assurance processes and select cases for internal review

Required Qualifications

• Graduation from an accredited school of nursing
• Active Registered Nurse (RN) or Licensed Vocational Nurse (LVN) license in California
• 2+ years of experience in Appeals and Grievances or Health Plan Customer Service
• 2+ years of experience managing work inventory to compliance metrics
• 2+ years of direct supervisory experience in managing or coordinating teams