Market Quality Improvement Specialist II

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $62.7k - $100.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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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

• Collaborate with department managers and leadership to evaluate opportunities for HEDIS data and process improvement • Conduct business process and gap analysis to diagnose process improvement opportunities and develop reusable solutions • Lead improvement work teams, including identifying team members, facilitating meetings, and managing projects • Support documentation of QIPs, PIPs, and other quality activities • Train, educate, and deploy improvement tools, methods, and processes • Analyze work processes to identify improvement opportunities • Establish and implement measurement and data collection methods • Review and measure progress and take appropriate action • Explore best practices across industries • Develop, evaluate, and implement survey tools • Analyze survey data to support improvement initiatives • Coordinate and participate in quality improvement committee meetings • Develop agendas, prepare minutes and presentations, and follow up on action items • Communicate with management, peers, staff, internal disciplines, outside agencies, and other entities • Track, compile, and report program and project metrics • Research, gather, and analyze data to identify improvement opportunities • Work with Maternal Child and Health Outcomes Management and Vendor Management to monitor vendor and community partner performance • Monitor vendor reporting and ensure timely receipt and accuracy of completed materials • Participate in workgroups and applicable committees • Prepare reports, briefing materials, and other deliverables • Perform other job-related instructions as requested

🎯 Requirements

• Bachelor’s degree or equivalent years of relevant work experience required • Minimum of three (3) years of healthcare or managed care experience required • Experience using the Model for Improvement (PDSA – Plan, Do, Study, Act) preferred • Medicaid and/or Medicare experience preferred • Knowledge of quality improvement methodologies including Model for Improvement, Lean, and 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 • Research, data analysis, and trending skills • Proficient in Microsoft Office Suite, including 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 with the healthcare 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 • CPHQ or ASQ certification preferred • Some in-state travel required, up to 10% of time

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • Equal Opportunity Employer environment focused on belonging and support • Remote work arrangement • Some in-state travel required, up to 10% of time

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