Market Quality Improvement Specialist II

This is a fully remote position, open to applicants in United States.

📋 Description

• Collaborate with department leaders and managers to assess opportunities for HEDIS data and process enhancement.

• Perform business process and gap analyses to identify areas for improvement and create reusable solutions.

• Lead teams focused on improvement initiatives, including identifying team members, coordinating meetings, facilitating discussions, and managing projects.

• Assist in documenting Quality Improvement Projects (QIPs), Performance Improvement Projects (PIPs), and other quality-related activities.

• Train, educate, and implement improvement tools, methodologies, and processes across designated departments.

• Analyze operational processes to uncover improvement opportunities.

• Establish and execute measurement and data-collection strategies in collaboration with management and improvement teams.

• Review and assess progress, taking necessary actions as required.

• Research industry best practices.

• Create, assess, and implement survey tools.

• Analyze survey results to guide improvement initiatives.

• Organize and engage in quality improvement committee meetings; create agendas, prepare meeting minutes and presentations, and follow up on action items.

• Communicate with upper management, colleagues, department personnel, internal teams, external agencies, and other stakeholders to share information and resolve issues.

• Monitor, compile, and report on program and project metrics.

• Research, collect, and analyze data to identify improvement prospects.

• Collaborate with Maternal Child and Health Outcomes Management and Vendor Management to evaluate vendor and community partner performance.

• Oversee monthly, quarterly, and annual vendor reports for prompt receipt and accuracy.

• Take part in workgroups and relevant committees.

• Prepare reports, briefing documents, and any other requested deliverables.

• Execute other job-related tasks as assigned.

⛳️ Requirements

• A Bachelor’s degree or equivalent years of relevant work experience is essential.

• A minimum of three (3) years of experience in healthcare or managed care is required.

• Familiarity with the Model for Improvement (PDSA – Plan, Do, Study, Act) is preferred.

• Experience with Medicaid and/or Medicare is preferred.

• Understanding of quality improvement methodologies, including the Model for Improvement, Lean, and Six Sigma.

• Skilled at guiding teams in establishing aim statements and identifying small tests of change.

• Proficient in creating and documenting PDSA cycles and key driver diagrams.

• Exceptional team facilitation abilities.

• Strong research, data analysis, and trending capabilities.

• Proficient in Microsoft Office Suite, including Word, Excel, and PowerPoint.

• Excellent written and verbal communication skills.

• Ability to formulate, prioritize, and achieve goals.

• Capability to work both independently and collaboratively within a team environment.

• Attention to detail is crucial.

• Familiarity with the healthcare sector.

• Knowledge of applicable Federal regulations, State regulations, and accreditation standards.

• Effective listening, critical thinking, and problem-solving abilities.

• Strong interpersonal skills and a high level of professionalism.

• Training and teaching skills.

• Certification as a Professional in Healthcare Quality (CPHQ) or American Society for Quality (ASQ) certification is preferred.

• Ability to sit or stand for extended periods in a typical office environment.

🏝️ Benefits

• Bonus opportunities linked to company and individual performance may be available.

• Comprehensive total rewards package.

• Commitment to an Equal Opportunity Employer environment that emphasizes belonging and support.

• Some in-state travel may be required, up to 10% of the time.