Clinical Quality Nurse Manager

Company: VirtualVocations
Location: Vista
Posted on: May 17, 2025

Job Description:

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

Keywords: VirtualVocations, Buena Park , Clinical Quality Nurse Manager, Healthcare , Vista, California

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