Quality Management Specialist - LHB

At Luminare Health, our people are what set us apart. Their expertise, dedication, and passion for service excellence are the foundation of our success.

We're committed to helping our employees grow through thoughtful development opportunities, meaningful work, and a culture that values collaboration and continuous improvement. When you join Luminare Health, you join a purpose-driven team focused on making healthcare simpler, better, and more affordable.
Job Summary
The Quality Management Specialist is responsible for the coordination and implementation of Quality Improvement Activities and Initiatives for the Healthcare Management Division (HCM). This role ensures compliance with all applicable state, federal, and accreditation requirements by managing licensure, regulatory standards, audits, and policy development. It leads and supports quality improvement activities by coordinating committees, monitoring performance metrics, conducting audits and root cause analyses, and overseeing accreditation and customer satisfaction processes. The position serves as a regulatory and quality compliance resource across the organization, collaborating cross‑functionally to educate staff and promote consistent, compliant, and high‑quality healthcare management operations.This is a Telecommute (Remote) role. Remote employees must live within the continental United States, excluding Alaska, California, Hawaii or New York. Sponsorship is not available
Minimum Job Requirements:

Active Unrestricted Registered Nurse License issued by a State or Territory of the United States of America

Minimum of 3 years clinical experience (e.g.: medical / surgical, community health nursing, home health nursing, etc.)

Read and interpret documents, criteria, instructions, and policy & procedure manuals;

Communicate in a positive and effective manner in both oral and written communication;

Write/create routine correspondence and reports

Speak effectively with clients, physicians, providers, families in crisis and community agencies as well as co-workers and senior management;

Capable of working in an environment that requires organization and prioritization in order to address time sensitive assignments;

Work independently with minimal supervision or instruction.

Work in a dynamic team-oriented environment;

Maintain high level of confidentiality, flexibility and willingness to learn new tasks;

Apply common sense understanding to carry out instruction furnished in written, oral or diagram form;

Deal with problems involving several concrete variables in standardized situations;

Evaluate problems, develop alternative solutions and identify trends and patterns;

Excellent interpersonal skills;

Perform multiple tasks simultaneously;

Add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals;

Compute rate, ratio and percent

Preferred Job Requirements:

Prior Quality Management experience in a managed care setting preferred

URAC/NCQA Accreditation experience highly preferred

Bachelor of Science with a major in Nursing preferred

This is a Telecommute (Remote) role. Remote employees must live within the continental United States, excluding Alaska, California, Hawaii or New York. Sponsorship is not available
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
EEO Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Pay Transparency Statement:
At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates.
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
Min to Max Range:
$57,800.00 - $108,500.00Exact compensation may vary based on skills, experience, and location.
Originally posted on Himalayas