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Quality Improvement Coordinator - Behavioral Health

Company: Centene Coproration
Location: Baton Rouge
Posted on: July 14, 2019

Job Description:

Description: Position Purpose: Position Responsibilities: Develop and implement the quality program description, work plan goals including applicable Healthcare Effectiveness Data and Information Set (HEDIS) measures and program evaluation (trilogy documents) for behavioral health Lead Behavioral Health Performance Improvement Projects (PIPS) Review clinical information for appeals to determine medical necessity Prepare cases for appeals that do not meet medical necessity Maintain files, logs, documentation including communication in accordance with National Committee for Quality Assurance (NCQA) and State standards and regulations including timelines Investigate and resolve behavioral health quality of care complaints and grievances

Keywords: Centene Coproration, Baton Rouge , Quality Improvement Coordinator - Behavioral Health, Healthcare , Baton Rouge, Louisiana

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