Quality Improvement Coordinator II - Clinical

Responsibilities

• Work with Director of Accreditation to assist with Plan compliance to NCQA/URAC standards
• Maintain Quality Improvement policies and procedures in compliance with NCQA/URAC requirements and recommend changes/enhancements as indicated
• Identify best practices, research new processes and recommend overall program enhancements
• Support the project life cycle including requirements gathering, creation of project plans and schedules, manage resources and facilitate project execution, deployment and closure
• Assist with collection and presentation of data for identified QI projects; identifying sources, methodology and timeliness for which data is needed
• Performs other duties as assigned
• Complies with all policies and standards

Preferred

• Bachelor's degree in Nursing or related medical field
• Hands on experience with writing and implementing policies and procedures to support NCQA/URAC or JCAHO accreditation standards
• Basic understanding of health insurance business, claims payment procedures, strategies and trends in health care

Benefits

• Health insurance
• 401K
• Stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• A flexible approach to work with remote, hybrid, field or office work schedules
• Nevada health insurance provider.
• Reno, Nevada, USA
• https://www.silversummithealthplan.com
• Growth Stage
• Recent News
• Vegas Inc Stories: Las Vegas Business News
• 40 Under 40: Kevin Murray, Manager of Housing & Justice Systems, SilverSummit Healthplan
• 2026-05-01
• Behavioral Health Business
• Nevada Division of Insurance Identifies Parity Violations Across Multiple Carriers
• 2026-02-27
• PR Newswire
• Amid NCI Budget Fears, Emerging Oncology Stocks Gain Attention
• 2025-07-08
• Company data provided by
• AI Tools
• Customize Your Resume
• Maximize your interview chances
• Build Cover Letter
• Make your application stand out
• Analyze How Well You Fit
• Understand your strength & weakness

Qualifications

• 3+ years clinical experience and 1+ years of experience in a quality function
• RN, LPN or LVN
• Current state nursing license
• Bachelor's degree in Nursing or related medical field
• Hands on experience with writing and implementing policies and procedures to support NCQA/URAC or JCAHO accreditation standards
• Basic understanding of health insurance business, claims payment procedures, strategies and trends in health care
• CPHQ
• 3+ years clinical experience and 1+ years of experience in a quality function.

Required skills

• CPHQ, Claims Payment Procedures, JCAHO Accreditation Standards, NCQA Accreditation Standards, Policy and Procedure Development, RN/LPN/LVN Nursing License, URAC Accreditation Standards

Preferred skills

• Bachelor's degree in Nursing or related medical field

Experience

• 3+ years