Process Improvement Specialist – Clinical

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

📋 Description

• Strategize, develop, and monitor process enhancement and operational projects aimed at improving clinical outcomes.

• Guarantee integration with delivery systems, encompassing service and care coordination.

• Act as the primary subject matter expert on clinical health outcomes.

• Assess clinical member materials, such as service coordination brochures, handbook references, and educational pamphlets.

• Function as a liaison for clinical initiatives, which include case and disease management, behavioral health, and HEDIS outcome measures.

• Analyze and evaluate responses on quality measures, including performance development and reporting.

• Offer suggestions for process improvements.

• Review both internal and external member survey outcomes for operational implications.

• Work in collaboration with the analytics team to enhance process improvement reporting and scheduling.

• Execute other tasks as assigned.

• Adhere to all policies and standards.

⛳️ Requirements

• Bachelor’s degree in Healthcare, a related field, or equivalent experience.

• Over 5 years of process improvement experience, ideally within a managed care setting.

• Experience in project coordination is preferred.

• Current RN or LCSW license in the state.

• Driver's license is preferred.

• Must be a resident of Michigan.

• Auditing experience is highly preferred.

🏝️ Benefits

• Competitive compensation.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement program.

• Paid time off in addition to holidays.

• Flexible work arrangements, including remote, hybrid, field, or office schedules.

• Additional incentives may be part of the total compensation package.