Grand Rapids, MI, United States
Healthcare, Nursing, Clinical Research
Clinical Program Specialist 2 (Priority Health)
Full-time with Benefits (A1)
GRAND RAPIDS, MI
Hours of Work:
8AM to 5PM
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Spectrum Health is a not-for-profit, award winning, integrated health system based in West Michigan. Our organization includes a medical center, regional community hospitals, a dedicated children's hospital, a multispecialty medical group and a nationally recognized health plan, Priority Health. We invest in our people by supporting a dynamic, high-performing workplace. Our collaborative approach to patient care includes a commitment to provide an exceptional experience for patients and their families. Spectrum Health supports successful career growth in an innovative environment.
Responsibility for coordinating the services supporting the multiple disciplines of NCQA accreditation and regulatory compliance requirements from both within and outside the health plan. Exercises independent judgment in the assessment,
development, maintenance, monitoring, evaluation, education and improvement of policies, procedures, processes and resources that support Medical Management’s operational and clinical excellence
Collaborates with clinical leadership to ensures compliance both internally and externally (delegated functions) with accreditation guidelines, and federal and state laws and requirements of regulated lines of business.
Education - Bachelor's Degree or equivalent in clinical healthcare, health administration, business, or related field
Experience - 2 years of experience typically gained through skills/knowledge/abilities in
legal, regulatory, or healthcare operations field; health insurance focus desireable; compliance auditor, or other audit function; project management/program development and implementation.
Registered Nurse (RN)
Education - Master's Degree or equivalent in related field
Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, sexual orientation, veteran status, or any other legally protected category.
Accommodation Notice, if you are a qualified individual with a disability, you may request a reasonable accommodation in Spectrum Health’s application process. Contact us at 616-486-2632
or if you prefer to use email, contact us at firstname.lastname@example.org
Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, sexual orientation, veteran status, or any other legally protected category. See more here
100 Michigan St. NE, Grand Rapids, MI 49503
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Website : http://www.spectrumhealth.org