Quality Improvement Project Manager

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

📋 Description

• Oversee and manage quality enhancement and organizational initiatives from start to finish, including NCQA and HEDIS preparations.

• Offer functional and technical expertise related to NCQA/HEDIS to departmental staff across the plan.

• Conduct educational sessions for both internal staff and external stakeholders as required.

• Organize work plans, teams, and resources for HEDIS/CAHPS submissions to the Connector Authority and NCQA.

• Analyze data and create presentations, committee materials, newsletter articles, and educational content.

• Design, execute, and oversee data review processes to guarantee report accuracy and integrity.

• Implement strategies to enhance HEDIS, CAHPS, and specified health measures.

• Comply with NCQA standards and assist in maintaining the Plan’s NCQA accreditation.

• Aid in corporate compliance coordination and external survey processes as necessary.

• Track project deliverables to ensure compliance with standards, including design documents, test plans, and operational documentation.

• Support the project life cycle by gathering requirements, planning and scheduling projects, managing resources, assisting with HEDIS audits, and overseeing execution, deployment, and closure.

• Manage data extractions and ongoing data oversight for HEDIS and QI project-management databases.

• Assess alternative data collection methods and evaluate ongoing methodologies and outcomes.

• Maintain comprehensive project documentation, including meeting notes, action items, issue lists, and risk management strategies.

⛳️ Requirements

• Must be eligible to work in the U.S. without the need for employment-based visa sponsorship now or in the future.

• Candidates must be residents of the state of Florida.

• Registered Nurse (RN), Licensed Practical Nurse, Licensed Clinical Social Worker (LCSW), or CPHQ certification is highly preferred.

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

• A Master’s degree in Public Health or a related discipline is preferred.

• At least 4 years of experience in quality improvement or project management within managed care.

• In-depth knowledge of HEDIS and NCQA standards.

• Proficient in Microsoft PowerPoint, Excel, and Access.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement programs.

• Paid time off in addition to holidays.

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

• Additional incentive options may be included in the overall compensation package.