QI Stars Clinical RN

About the role

Built to Care. Driven to Improve. At Community Health Choice, we’re a nonprofit health plan dedicated to improving the health and well-being of Texans, especially underserved communities. Our employees bring purpose into practice every day through compassion, collaboration, and a commitment to better outcomes.

Responsibilities

• Supports quality performance improvement across Community Health Choice’s Medicare Advantage and Medicaid lines of business.
• Focuses on improving Centers for Medicare and Medicaid Services (CMS) Part C Star Ratings.
• Drives data-informed initiatives.
• Manages gap closure strategies.
• Supports cross-functional alignment to improve outcomes and compliance across all quality measures.

Qualifications

• Bachelor’s degree in Public Health, Nursing, Healthcare Administration, or related field.
• Registered Nurse, current license within the state of Texas. License must be active and in good standing.
• 3-5 years of experience in health plan quality improvement, Medicaid quality, or managed care, with 1 year of Quality Improvement experience.
• Microsoft Office (Word, Excel, PowerPoint, Outlook) and Visio.
• Strong working knowledge of CMS Star Ratings, HEDIS, and CAHPS.
• Experience presenting data to providers and supporting practice transformation.
• Excellent communication, relationship management, and organizational skills.

Preferences

• Master’s degree in Public Health or Healthcare Management or related field.
• Clinical Quality, Public Health, or Healthcare; Certified Professional in Health Quality (CPHQ).
• Familiarity with state CMS D-SNP model of care requirements.
• Data visualization tools (e.g., Tableau, Power BI).

Benefits

Community employees' benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and options to meet your specific needs. Community is an Equal Opportunity Employer. Harris Health's benefits program is designed to provide you with greater flexibility and more choices to meet your specific needs. Harris Health's benefits program allows you to protect your income in case of illness, death, and disability, and to help you save for retirement.