Responsible for applying nursing knowledge to improve clinical quality. Assesses data to identify high risk and rising risk patients across all insurance payors. Possesses expertise in quality improvement or risk management programs, claims reviews, or health insurance related proceedings. Principal Accountabilities: Advanced skills with Microsoft Office applications (Word, Excel, Access, Powerpoint) + Ability to query systems, abstract data, and create meaningful reports using data queries + Strong critical thinking skills and ability to create subject/disease specific education + Ability to manage multiple priorities and meet requested timelines + Strong written and verbal communication skills + Ability to work collaboratively on projects with people from other departments/practice locations + Ability to be flexible, some travel to practice locations required Required: Graduate of an accredited School of Nursing; Preferred: + Experience as a Case Manager or Health Insurance background + Bachelor's degree in Nursing preferred