Healthcare Quality Implementations – Integrations Specialist

Job not on LinkedIn

🔥 19 hours ago

🇺🇸 United States – Remote

💵 $72.2k - $115.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Support the Quality function of new business market and product implementations and integrations • Review and understand current and prospective contracts • Inform proposal content and identify, collect, and manage documentation for RFPs and other business-related proposals • Serve as a Quality liaison between the Enterprise Implementation Organization, Enterprise Project Management Organization, and Quality & Performance Organization • Partner with Quality sub-functions, IT, and IMO to ensure on-time delivery and operational readiness of sustainable business solutions • Support Epic and Feature development related to new market/product implementations and CSMS affiliate integrations • Draft governing documents, including QI Program Descriptions, work plans, charters, and policies and procedures • Support desktop readiness and Go-Live readiness reviews • Drive continuous quality improvement by incorporating innovative approaches and lessons learned • Build and maintain relationships with internal and external stakeholders • Assist Quality & Performance Outcome teams with EQRO and NCQA readiness • Review RFP opportunities and advise proposal writers on content development • Review and analyze cross-functional data for RFP and proposal requirements • Develop and maintain repositories for quality-related internal and external data • Evaluate state or federal priorities, perform market research, and complete epidemiological studies • Collect supplemental documentation, appendices, and forms for contracts and proposals • Proofread and revise proposal documents • Complete Model of Care SNP documentation, including Population Assessment and Quality Improvement requirements • Compile success stories and metrics for RFP content • Collect quality-improvement proposal commitments and coordinate cross-functional implementation • Support other Quality functional areas in new market and product implementations • Perform other job-related duties as requested

🎯 Requirements

• Bachelor's degree required • Equivalent years of relevant work experience may be accepted in lieu of required education • Five (5) years of Managed Care experience, preferably within Quality Management/Improvement required • Proficiency in Microsoft Office tools, including PowerPoint, Word, Excel, Teams and Outlook • Effective listening and critical-thinking skills • Analytical and timely problem-solving skills • Interpersonal and relationship-building skills • Ability to effectively interact with all levels within the organization • Effective written and verbal communication skills • Strong knowledge of Managed Care and Quality Management, including NCQA accreditations • Ability to work independently and within a team environment • Detail-oriented with strong organizational and time-management abilities • Current CPHQ certification preferred • General office environment; may be required to sit or stand for extended periods • Up to 15% occasional travel may be required

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • Remote work arrangement • Equal opportunity and inclusive workplace environment