Market Quality Improvement Specialist II
Job Summary:
The Market Quality Improvement Specialist II collaborates with department manager and other leadership to evaluate opportunity for HEDIS data and process improvement in new or existing projects with focus on measurable benefits.
Essential Functions:
Conducts business process and gap analysis to diagnose process improvement opportunities and to develop re-usable solutions using principles of process excellence and related tools
Directly responsible for improvement work teams, to include: working with management to identify the appropriate team members, coordination and facilitation of team meetings and management of improvement work team projects
Collaborates with management team to support necessary documentation of QIPs and PIPs and other quality activities
Trains, educates and deploys improvement tools, methods and processes throughout the departments assigned
Analyzes work processes using improvement tools and methodology to identify improvement opportunities
Works with management and the improvement team to establish and implement effective measurement and data collection methods
Reviews and measures progress with management and work team and takes appropriate action
Explores best practices across various industries to bring to the work team
Develops, evaluates and implements survey tools
Analyzes data from survey sources in order to provide input into improvement initiatives
Coordinates and participates in quality improvement committee meetings; develops agendas, prepares meeting minutes, prepares and makes presentations, and follows-up on action items
Communicates in a clear, concise, and complete manner with upper management, peers, department staff, other disciplines within the organization, outside agencies and other entities to ensure prompt and proper exchange of information and resolution of issues
Assist with tracking, compiling and reporting program and project metrics
Research, gather and analyze data to identify improvement opportunities
Work closely with Maternal Child and Health Outcomes Management and Vendor Management to monitor vendor and community partner performance
Monitor monthly/quarterly/annual reporting of vendors and ensure timely receipt and accuracy in completed material
Participate in workgroups and applicable committees
Prepare reports, briefing materials and other requested deliverables for programs and projects
Perform any other job related instructions as requested
Education and Experience:
Bachelor’s degree or equivalent years of relevant work experience is required
Minimum of three (3) years of healthcare or managed care experience is required
Experience using the Model for Improvement (PDSA – Plan, Do, Study, Act) is preferred
Medicaid and/or Medicare experience is preferred
Competencies, Knowledge and Skills:
Knowledge of a variety of quality improvement methodologies – Model for Improvement, Lean, Six Sigma
Proficient in leading teams through establishing aim statements and identifying small tests of change
Proficient in establishing and documenting PDSA cycles and key driver diagrams
Excellent team facilitation skills
Ability to engage teams in a positive, energetic manner
Research, data analysis and trending
Proficient in Microsoft Office Suite to include Word, Excel and PowerPoint
Excellent written and verbal communication skills
Ability to develop, prioritize and accomplish goals
Ability to work independently and within a team environment
Attention to detail
Familiarity of the health care field
Familiarity with applicable Federal regulations, State regulations, and accreditation standards
Effective listening and critical thinking skills
Strong interpersonal skills and high level of professionalism
Effective problem solving skills with attention to detail
Training/teaching skills
Licensure and Certification:
Certified Professional in Healthcare Quality (CPHQ) or American Society for Quality (ASQ) certification preferred
Working Conditions:
General office environment; may be required to sit or stand for extended periods of time
Some in state travel is required (up to 10% of time)
Compensation Range:
$62,700.00 - $100,400.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
Fostering a Collaborative Workplace Culture
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
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