About the position
Responsibilities
• Oversee and implement healthcare quality improvement initiatives and education programs.
• Conduct data collection, reporting, and monitoring for key performance measurement activities.
• Direct and implement NCQA accreditation surveys and federal/state QI compliance activities.
• Initiate and manage provider, member, and community interventions to remove barriers to care.
• Prepare for Quality Improvement Compliance surveys and other required quality activities.
• Monitor and ensure timely and accurate completion of key quality activities.
• Write narrative reports interpreting regulatory specifications and documenting findings.
• Create and manage documentation to maintain critical quality improvement functions.
• Lead quality improvement activities and discussions with other departments.
• Evaluate project/program activities to identify opportunities for improvement.
Requirements
• Bachelor’s Degree or equivalent combination of education and work experience.
• Minimum 3 years’ experience in healthcare with at least 1 year in health plan quality improvement or managed care.
• Demonstrated solid business writing experience.
• Operational knowledge and experience with Microsoft Excel and Visio.
Nice-to-haves
• 1 year of experience in Medicare and Medicaid.
• Certified Professional in Health Quality (CPHQ) certification.
• Nursing License (RN may be preferred for specific roles).
• Certified HEDIS Compliance Auditor (CHCA) certification.
Benefits
• Health insurance
