Job Description
We are hiring a **Supervisor for Clinical Quality Assurance** here at BCBST to lead a high-performing team of nurses statewide.
In this role, you will guide clinical reviews of medical records, partnering with provider offices to enhance documentation, strengthen patient education, and close gaps in care. Reviews include EPSDT reviews for Medicaid, as well as comprehensive medical record reviews for all lines of business and office site visits for newly credentialed providers. Your team will also play a key role in the annual HEDIS project through hybrid medical record reviews and supplemental data analysis. This is an opportunity to drive meaningful improvements in care quality by collaborating across teams to ensure our members receive the highest standards of service.
The ideal candidate demonstrates strong leadership capability, excellent teaching and communication, effectively managing competing priorities, and delivering measurable results that advance organizational goals....
In this role, you will guide clinical reviews of medical records, partnering with provider offices to enhance documentation, strengthen patient education, and close gaps in care. Reviews include EPSDT reviews for Medicaid, as well as comprehensive medical record reviews for all lines of business and office site visits for newly credentialed providers. Your team will also play a key role in the annual HEDIS project through hybrid medical record reviews and supplemental data analysis. This is an opportunity to drive meaningful improvements in care quality by collaborating across teams to ensure our members receive the highest standards of service.
The ideal candidate demonstrates strong leadership capability, excellent teaching and communication, effectively managing competing priorities, and delivering measurable results that advance organizational goals....