[Hiring] QI Specialist I @LanceSoft

Role Description

Responsible for developing, organizing, collecting, coordinating, preparing and presenting results of quality improvement studies and projects activities to monitor, evaluate and continuously improve the quality of healthcare services provided to members.

• Collaborates with the Quality Improvement department staff in the development of quality improvement studies, initiatives and projects to improve the health care of members.
• Plans and coordinates the collection, evaluation and dissemination of quality improvement data for quality initiatives, studies and projects to comply with regulatory requirements and accreditation standards.
• Prepares reports and analyses to evaluate performance with standards from a variety of sources such as materials, documents, medical charts, provider offices, and/or facilities.
• Performs qualitative and quantitative analysis to identify significant and problematic clinical issues and concerns, development of improvement plans and measurement to assess impact of actions.
• Participates in NCQA accreditation and regulatory audit preparedness and maintains activities including preparing reports, narratives, graphs, charts, etc. as needed for external audits and surveys.
• Participates in and facilitates quality improvement program committees, as assigned, including preparing materials, minutes and tracking action items for committee review.
• Develops and maintains Quality Improvement department policies and procedures, materials and reports in accordance with State, Federal, and NCQA requirements.

Qualifications

• Bachelor's Degree in Public Health or related healthcare field (equivalent experience in lieu of a Bachelor's).

Requirements

• 0-2 years experience in Quality Improvement.
• 0-2 years experience in managed care or healthcare industry.
• Experience with qualitative or quantitative projects/analysis.
• Proficiency with PC-based systems.
• Excellent verbal and written communication skills.
• Ability to abide by policies.
• Ability to maintain attendance to support required quality and quantity of work.
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.