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 improvement in HEDIS data and processes.

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

• Oversee improvement work teams, which includes selecting team members, facilitating meetings, and managing projects.

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

• Train and educate staff on improvement tools, methods, and processes.

• Analyze work processes to uncover improvement opportunities.

• Establish and implement methods for measurement and data collection.

• Review progress and take necessary actions based on findings.

• Investigate best practices from various industries.

• Develop, evaluate, and implement tools for surveys.

• Analyze survey data to support initiatives for improvement.

• Coordinate and engage in quality improvement committee meetings.

• Create agendas, prepare minutes and presentations, and follow up on action items.

• Communicate effectively with management, peers, staff, internal departments, outside agencies, and other stakeholders.

• Track, compile, and report metrics related to programs and projects.

• Research, collect, and analyze data to identify areas for improvement.

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

• Monitor vendor reporting and ensure the timely receipt and accuracy of completed materials.

• Participate in workgroups and relevant committees.

• Prepare reports, briefing documents, and other deliverables.

• Carry out additional job-related tasks as assigned.

⛳️ Requirements

• A Bachelor’s degree or an equivalent amount of relevant work experience is required.

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

• Experience 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.

• Proficient in guiding teams to establish aim statements and identify small tests of change.

• Skilled in establishing and documenting PDSA cycles and key driver diagrams.

• Exceptional team facilitation abilities.

• Strong research, data analysis, and trending capabilities.

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

• Excellent written and verbal communication skills.

• Ability to set, prioritize, and achieve goals.

• Ability to work independently as well as collaboratively within a team.

• Strong attention to detail.

• Familiarity with the healthcare sector.

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

• Effective listening and critical thinking skills.

• Strong interpersonal skills and a high level of professionalism.

• Effective problem-solving abilities with a focus on detail.

• Skills in training and teaching.

• CPHQ or ASQ certification is preferred.

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

🏝️ Benefits

• A bonus linked to both company and individual performance may be available.

• A comprehensive and substantial total rewards package is offered.

• An Equal Opportunity Employer environment that emphasizes belonging and support.

• Flexible remote work arrangements.

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