Apply on Employer Site

Telligen · 19 hours ago

Clinical Quality and Compliance Coordinator

Oklahoma, United States

Full-time

Onsite

Entry, Mid Level

2+ years exp

Telligen is one of the most respected population health management organizations in the country. The Clinical Quality and Compliance Coordinator will be responsible for coordinating quality assurance, quality improvement, accreditation, regulatory compliance, and credentialing activities across clinical programs, ensuring timely and accurate completion of quality initiatives and supporting audit activities.

Health Care

Culture & Values

No H1B

Responsibilities

Support quality assurance (QA) and quality improvement (QI) activities for assigned contracts and clinical programs

Track quality deliverables, performance measures, and improvement activities to ensure timely and accurate completion

Maintain documentation related to Plan-Do-Study-Act (PDSA) cycles and other quality improvement initiatives

Support corrective action plans (CAPs) through documentation, tracking, and follow-up activities

Assist with audit and monitoring activities, including clinical file reviews, documentation audits, and compliance checks

Execute audits using approved audit tools and methodologies

Assist with the development, maintenance, and refinement of audit tools, checklists, and templates under direction, including mapping to applicable accreditation and regulatory standards

Compile audit materials, document findings, and assist with trend analysis and issue tracking

Maintain audit logs, trackers, and evidence repositories to support remediation and reporting

Support accreditation readiness activities for URAC, NCQA, and other applicable accrediting bodies

Assist with the collection, organization, and submission of accreditation and regulatory evidence

Maintain accreditation trackers, compliance logs, and documentation repositories

Support preparation and maintenance of state Utilization Review Organization (URO) applications, renewals, and amendments under direction

Support credentialing and recredentialing activities for clinical staff and delegated entities

Assist with primary source verification (PSV) documentation collection and file organization

Maintain credentialing logs, trackers, and audit documentation

Support credentialing audits and corrective action activities as assigned

Assist with the development and updating of staff education materials related to quality, compliance, accreditation, and credentialing under direction

Draft training materials, job aids, and reference documents and update existing education based on policy or regulatory changes

Support delivery of onboarding and refresher education sessions as assigned

Track training completion and maintain required documentation

Support policy and procedure maintenance through formatting, version control, and document management

Prepare draft reports and summaries for leadership and committee review

Qualification

Registered Nurse (RN)Quality Assurance (QA)Quality Improvement (QI)URAC standardsNCQA standardsClinical documentation reviewAccreditation complianceCredentialing activitiesPDSA cyclesHealthcare operationsTraining materials developmentDocument managementSoft skills