Clinical Quality Nurse Manager

A company is looking for a Clinical Quality Call Center Nurse Manager - Remote. Key Responsibilities Supervise and coordinate a team to ensure compliance with regulatory initiatives and performance targets Handle escalated calls and assist members with inquiries Conduct performance reviews and support leadership in monitoring metrics for STAR performance Required Qualifications Undergraduate degree or equivalent experience 5+ years of managerial experience in a healthcare setting Extensive knowledge of Medicare Part D, including pharmacy record review and billing rules Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements Prior work experience in STARS and clinical Medicare Part C gap closures

May 16, 2025 - 23:16

A company is looking for a Clinical Quality Call Center Nurse Manager - Remote. Key Responsibilities Supervise and coordinate a team to ensure compliance with regulatory initiatives and performance targets Handle escalated calls and assist members with inquiries Conduct performance reviews and support leadership in monitoring metrics for STAR performance Required Qualifications Undergraduate degree or equivalent experience 5+ years of managerial experience in a healthcare setting Extensive knowledge of Medicare Part D, including pharmacy record review and billing rules Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements Prior work experience in STARS and clinical Medicare Part C gap closures