Quality Improvement Specialist
Altoona, PA - USA
Job Summary
To support and help implement quality improvement initiatives at the direction of the QI Manager through coordination and collaboration both externally and internally. Help improve quality metrics through process improvement.
Essential Position Functions
- Participate in QI initiatives quality metrics and pay for performance measures.
- Investigate track trend and analyze reported quality/adverse events.
- Work collaboratively with the QI Manager and Market Leader CMO to provide feedback and maintain strong relationships with external vendors/entities related to HEDIS Performance Improvement Projects (PIPs) and NCQA projects.
- Track PIP data and write quarterly PIP reports PIP proposals and final PIP reports.
- Engage and educate members on QI initiatives regarding gap closure.
- Engage and educate providers on QI initiatives and P4P measures and work with providers to develop processes to improve QI/P4P measures.
- Attend and participate in quarterly QI Committee meetings.
- Attend and participate in monthly credentialing meetings.
- Collaborate with other departments to accomplish QI initiatives.
- Complete provider site visits per NCQA standards.
- Minimum of an Associate degree or certification in related field.
- Nursing or clinical experience preferred.
- Proficient in the use of Microsoft Office Suite.
- Ability to build trust with business partners across organizational boundaries.
- Strong interpersonal skillsability to effectively communicate with all levels and functional areas within the organization.
- Strong written and verbal communication skills.
- Ability to work independently.
The Cooperative is committed to fostering a caring and compassionate environment while ensuring that individual differences are valued. The Cooperative is a quality driven cooperative built on collaboration community involvement innovation and belonging. It is essential that all employees and members feel secure and welcome that the opinions and contributions of all individuals are respected and that all voices are heard.
This full time position offers an outstanding benefit package including three weeks of vacation the first year a generous retirement plan health and dental insurance a wellness program and much more! If you are interested in working for an organization focused on a team atmosphere and is dedicated to providing exceptional service submit your resume today! Send resume to: Group Health Cooperative of Eau Claire is an affirmative action and equal opportunity employer.
Required Experience:
IC
About Company
Group Health Cooperative is a community-based non-profit health plan that delivers high-quality, personalized service to its members. The Cooperative started as a local coalition more than 40 years ago. While it is still a local plan with a local focus, it is now a nationally recogniz ... View more