Quality Management Coordinator RN

About the position All about us You likely know us as an insurance company, but that’s just a portion of what we do. Hundreds of thousands of North Dakotans trust us to provide them with personalized service and unmatched access to care. It’s a mission we take seriously. We also work with entities throughout the state to challenge the cost and complexity of health care in North Dakota. This uncompromising goal requires caring, innovative people who are ready and willing to help create a new level of health and well-being in North Dakota and beyond. Our Strategic Affiliation with Cambia In 2026, BCBSND and Cambia Health Solutions formed a strategic affiliation to enhance access to simpler, more affordable health care while keeping a strong local focus. The affiliation was approved by North Dakota regulators and became effective Feb. 1, 2026. Under this affiliation, BCBSND employees became Cambia employees while continuing to serve the BCBSND market. Day‑to‑day work and hiring continue as usual. Work environment Although this role supports remote, hybrid, or in‑office work, if the selected candidate chooses a remote arrangement, they must reside within approximately 300 miles of Fargo, ND, to allow for periodic travel as needed. We empower our employees to find a work style that is best for them. Learn more at Life at Blue | BCBSND . This position is eligible for internal Blue Cross Blue Shield employees and external applications. Pay information Pay Level: 24 FLSA Category: Exempt – Salary Individual pay will be based on skills, experience, qualifications, location, internal equity, and other relevant factors Opportunities for continued salary growth through a performance-based merit program The estimated starting pay for this position is between $72,550 - $100,000 At BCBSND, we’re committed to providing fair and equitable compensation. While the posted salary range reflects the full compensation range for this role, offers typically fall at or below the midpoint, and in alignment with internal equity and role expectations. Individual offers are based upon candidates’ unique experience, education, and skillsets. The top of the range reflects the ceiling for this role and is only used for offers in exceptionally rare cases. We do not extend offers above the posted maximum. A day in the life The Quality Management Coordinator (Registered Nurse) is responsible for supporting the overall functions of the Quality Management Program, ensuring the program’s activities are following state and federal regulations and all other recognized quality standards. Additionally, this position provides support, coordination, and facilitation of quality measures to participating providers.

Responsibilities

• Supports Quality Management Program to ensure the effectiveness of the program.
• Identifies performance measures for the program’s activities, tracks performance against these measures and develops an action plan(s) to address issues.
• Supports the development, implementation and annual review of policies and procedures.
• Coordinates reporting of quality management activities to the various committees and Department of Insurance (DOI).
• Oversees annual collection, analysis and reporting of health care information to fulfill quality measures reporting requirements.
• Partners with internal departments, vendors, and auditors.
• Supports management of the accreditation and reaccreditation process, assures desktop submission requirements and timelines are met, facilitates onsite validation reviews, and educates staff on accreditation process and standards.
• Coordinates the activities for quality programs.
• Participates in scheduled group conference calls, provides program information to eligible providers, assists providers with application and submission and provides notification regarding designations.
• Reports program updates to internal committees and staff as appropriate.
• Serves as a resource and participates in appropriate special projects, audits or other activities as requested.
• Provides support, education and coaching to participating providers in meeting specific quality measures by facilitating conference calls and on-site visits.
• Partners with internal and external stakeholders to understand data needs and delivery of insightful solutions.

Requirements

• An associate's degree in an RN program is required. A BSN is highly preferred.
• 5 years of experience in nursing, clinical quality management, accreditation, insurance, or related experience.
• North Dakota (ND) Registered Nurse (RN) License or RN License valid for work in ND is required.
• Must maintain an active and valid/unencumbered driver’s license which allows for standard driving privileges in North Dakota and Minnesota.
• Strong attention to detail and a high level of accuracy in all work.
• Ability to organize, prioritize, and manage workload effectively in a fast-paced environment.
• Solid technical and professional knowledge with the ability to learn and apply new skills.
• Ability to build and maintain positive working relationships with internal and external stakeholders.
• Skill in conducting research, analyzing data, and drawing meaningful conclusions.
• Effective presentation skills with the ability to communicate information clearly and professionally.
• Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

Nice-to-haves

• Experience with Medicaid management care is highly preferred.

Benefits

• Affordable medical, dental and vision coverage accepted throughout the United States
• Employer funded Lifestyle Spending Accounts and Health Savings Accounts.
• Voluntary employee contributions to Health Savings Accounts and Flexible Spending Accounts
• Employer-paid life and disability insurance
• 401(k) retirement plan with company match and immediate vesting
• Paid holidays, paid time off (PTO), PTO donation program, and paid parental leave
• Voluntary benefits including Accident, Hospital Indemnity, Critical Illness, Term/Whole Life, Cancer Care Insurance, and more.
• Additional company perks
• Robust mental health offerings including an Employee Assistance Program, Learn to Live, meQ.
• Comprehensive learning and development opportunities and an Educational Assistance Program.
• 16 hours of paid volunteer time with a $200 donation to a charity of your choice upon completion of all volunteer hours.
• Employee recognition, community initiative events and yearly company outings.
• Workplace flexibility offering different options for working arrangements and the freedom to make time for important commitments.
• Opportunities to connect through employee committees.

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