Quality Improvement Project Manager

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

📋 Description

• Oversee and track quality enhancement and organizational initiatives from start to finish.

• Organize the Work Plan, team, and resources for HEDIS/CAHPS submissions to the Connector Authority and NCQA.

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

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

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

• Design, execute, and manage the data review process to ensure the accuracy and integrity of data reports.

• Coordinate and implement strategies to enhance HEDIS, CAHPS, and other designated health metrics.

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

• Aid in the coordination of corporate compliance and external surveys.

• Supervise the creation of project deliverables, which includes design documents, test plans, and operational documentation.

• Support the project life cycle through gathering requirements, project planning, scheduling, resource management, HEDIS audit support, execution, deployment, and closure.

• Organize data extraction and manage ongoing data for HEDIS and QI project management databases.

• Assess alternative data-capture methods and evaluate ongoing methodologies and outcomes.

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

⛳️ Requirements

• Must be legally authorized to work in the U.S. without requiring employment-based visa sponsorship now or in the future.

• Eligible candidates must reside in the state of Florida.

• Preferred candidates should hold a Registered Nurse (RN) license, Licensed Practical Nurse, Licensed Clinical Social Worker (LCSW), or CPHQ certification.

• Bachelor’s degree in Healthcare, Business, or equivalent experience is required.

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

• A minimum of 4 years of experience in quality improvement or project management within managed care is required.

• Advanced knowledge of HEDIS and NCQA is essential.

• Proficiency in Microsoft applications, including PowerPoint, Excel, and Access, is required.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase plans.

• Tuition reimbursement program.

• Paid time off, in addition to holidays.

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

• Additional incentives may be included in total compensation.