Quality Improvement Specialist

Site: Mass General Brigham Health Plan Holding Company Inc.

Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

The Quality Project Management Specialist is responsible for coordinating and managing projects aimed at improving the quality of care ensuring compliance with regulatory standards and enhancing member satisfaction within the health plan. This role involves the development implementation and evaluation of quality improvement initiatives working closely with cross-functional teams to achieve organizational goals. The Specialist will oversee and lead projects from initiation to completion ensuring that they are completed on time within scope and on budget. The role requires a strong understanding of project management methodologies processes and tools; driving project teams coordinating resources and is the primary point of contact for stakeholders.

Essential Functions
Project Management
Lead and manage multiple quality improvement projects across the health plan ensuring they are completed on time within scope and meet the organizations objectives.
Develop project plans timelines budgets and resource allocations adjusting as necessary to ensure project success.
Monitor project progress and identify risks issues or delays implementing corrective actions as needed.
Communicate regularly with internal and external stakeholders to ensure expectations are managed issues are addressed and the project is on track
Work with cross-functional teams ensuring that roles and responsibilities are clearly defined and progress is tracked.
Proactively identify and mitigate project risks and issues adjusting plans as necessary to ensure project success.
Monitor and control project budgets ensuring resources are used efficiently and effectively.
Ensure that deliverables meet the required quality standards and stakeholder expectations.
Provide regular status updates and detailed reports to leadership and stakeholders documenting all project activities milestones and changes.

Quality Improvement
Drafting reviewing and revising internal policies and procedures to ensure alignment with industry standards legal requirements and best practices.
Support quality improvement (QI) projects using methodologies such as PDSA Lean or Six Sigma.
Support the development and implementation of health plan quality improvement initiatives focused on improving clinical outcomes operational efficiency and customer satisfaction.
Monitor and analyze health plan performance data to identify areas for improvement developing actionable insights and solutions.
Collaborate with clinical teams operations and IT to ensure quality metrics are met and quality programs are integrated across the health plan.
Ensure that quality projects align with state and federal regulations such as CMS (Centers for Medicare & Medicaid Services) standards NCQA (National Committee for Quality Assurance) requirements and other applicable regulatory frameworks.
Monitor and support audits and reporting requirements related to quality measures and performance metrics.
Collect analyze and interpret data related to health plan quality including clinical operational and member satisfaction data.
Prepare and present reports on project progress outcomes and key performance indicators (KPIs) to senior leadership and stakeholders.

Other duties as assigned

Education

• Bachelors Degree Related Field of Study required (experience can be substituted in lieu of degree); Masters degree preferred

License

• Project Management Professional (PMP) certification preferred
• Certification in healthcare quality or equity (e.g. CPHQ CPHE Lean Six Sigma etc.) preferred

Experience

• At least 2-3 years of experience in Quality Improvement preferably in a healthcare setting required
• At least 5 years in health plan quality in a manager care organization highly preferred
• At least 3 years in project management highly preferred
• Experience in healthcare quality health equity initiatives population health or related program coordination highly preferred
• Familiarity with QI methodologies and regulatory standards highly preferred

Knowledge Skills and Abilities

• Strong understanding of document management systems (DMS) such as SharePoint OpenText or Documentum to manage digital files track revisions and maintain version control.
• Familiarity with cloud storage systems and collaboration tools like Google Drive Dropbox and Microsoft OneDrive.
• Experience with electronic records management (ERM) and data retention policies.
• Demonstrates awareness of importance of security scalability reliability and feasibility in solutions
• Seeks out information to better understand impacts of design and implementation of systems
• Evaluates service areas to identify opportunities for automation
• Ability to draft revise and implement company policies and standard operating procedures.
• Knowledge of compliance standards including industry-specific regulations (e.g. healthcare HIPAA regulations financial regulations state and federal rules).
• Strong organizational skills to ensure policies and documents are properly filed categorized and easy to access.
• Breaks complex topics into meaningful chunks of information.
• Seeks out multiple sources to gather information.
• Understanding of legal and regulatory requirements for document retention and management including data privacy and security laws.
• Knowledge of audit procedures and the ability to prepare documentation for audits.
• Excellent written and verbal communication skills for drafting policies and procedures as well as providing guidance to employees about document handling and compliance.
• Ability to train staff on document management practices and policy changes.
• Experience using document management software and workflow tools to streamline document processes and improve efficiency.
• Proficiency in Microsoft Office Suite (Word Excel PowerPoint Outlook) and other productivity tools is often required.
• Familiarity with document control software for versioning workflow management and access permissions.
• Ability to manage multiple tasks or projects simultaneously adhering to deadlines and ensuring that policies and documents are up to date.
• Experience with project management software such as Trello or Microsoft Project is beneficial.
• Ability to identify issues with document flow retention or compliance and propose solutions to resolve them.
• Strong critical thinking skills for analyzing policies and procedures to ensure they align with organizational goals and legal requirements.
• Excellent interpersonal skills including the ability to influence others at all levels of an organization.

Working Conditions

• Remote with up to 8 visits per year on-site

Remote

399 Revolution Drive

40

Regular

Day (United States of America)

Pay Range

$62400.00 - $90750.40/Annual

Grade

6

At Mass General Brigham we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive and any offer extended will take into account your skills relevant experience if applicable education certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however it does not encompass all elements contributing to your total compensation addition to competitive base pay we offer comprehensive benefits career advancement opportunities differentials premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

Mass General Brigham Health Plan Holding Company Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religious creed national origin sex age gender identity disability sexual orientation military service genetic information and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973 the Vietnam Veterans Readjustment Act of 1974 and Title I of the Americans with Disabilities Act of 1990 applicants who require accommodation in the job application process may contact Human Resources at .

Mass General Brigham Competency Framework