[Hiring] Quality Improvement Specialist @Mass General Brigham

Role Description

This role is collecting and reviewing NCQA documentation from stakeholders throughout MGB Health Plan. This person will be a resource about NCQA requirements to stakeholders throughout MGB Health Plan.

The Quality Improvement Specialist plays a key role in ensuring that the department performs at the highest levels on standardized, national measures of clinical care quality and accreditation. Ensures the accurate and timely collection of data from clinical records, identifies opportunities for improvement, communicates and works collaboratively with multidisciplinary improvement teams and facilitates the creation and implementation of improvements in care processes.

Essential Functions

• Assist with the development and coordination of all documentation needed to successfully maintain NCQA accreditation.
• Support the development of quality improvement performance audit function processes and tools.
• Assist in designing, running, managing, and data review process for assuring accuracy and integrity of health services data reports to meet regulatory and operational requirements.
• Report outcomes and quality monitoring results to management.
• Assist with managing databases, policies and procedures related to assigned areas.
• Assist with related activities for various committees and meetings for assigned areas.
• Support vendor/delegate oversight.
• Consults on quality issues and develops solutions.

Qualifications

• Bachelor's Degree required; experience can be considered in lieu of education.
• Experience in Quality Improvement, preferably in a healthcare setting 2-3 years required.
• NCQA Health Plan and/or Health Outcomes Accreditation experience highly preferred.
• Demonstrated knowledge and use of quality improvement methodologies and tools.
• Strong interpersonal skills necessary to establish supportive, collegial relationships, and to interact effectively with administrative and clinical leadership, staff, clinical leads, and other healthcare professionals.
• Ability to manage multiple projects simultaneously and adhere to work deadlines.
• Excellent verbal and written communication skills.
• Excellent computer skills including Microsoft Office (Word, Excel, PowerPoint, Access), Flowcharting/mapping (QI Charts).
• Ability to learn and effectively use computer software, such as electronic health records and data entry tools.

Requirements

• This is a remote role that can be done from most US states.
• This role is Monday through Friday, business hours EST.
• Scheduled Weekly Hours: 40.
• Employee Type: Regular.
• Work Shift: Day (United States of America).
• Pay Range: $63,648.00 - $90,750.40/Annual.
• Grade: 6.

Benefits

• Competitive salaries.
• Flexible work options.
• Career growth opportunities.
• Comprehensive benefits.
• Recognition programs designed to celebrate contributions and support professional growth.