Position Title: Quality Improvement Specialist
Work Location: Remote - US (Anywhere in US)
Assignment Duration: 6 months (possible to extend or convert)
Work Arrangement: Remote
Position Summary: Support the development and maintenance of quality improvement related projects and reporting.
Background & Context: Risk adjustment department of The Organization's PA health and wellness. Team works directly with providers on members’ outstanding chronic conditions and partners with Quality and Provider Engagement.
Key Responsibilities:
• Monitor performance on established contractual quality indicators.Analyze, track and trend results. Prepare formal written reports for the Quality Management Committee and Executive Management.
• Recommend, develop, and implement quality performance improvement plans (PIPs) with management utilizing the PDSA model. Monitor and report PIPs progress through closure.
• Train providers and staff in methodologies and tools of continuous quality improvement.
• Prepare for and participate in meetings with various committees, State agencies, providers, and stakeholders.
• Provide clinical support to the medical record audit processes.
Working Conditions & Physical Demands (If Applicable): Daily schedules are flexible and vary based on business needs. Largely self-directed with support from leadership and peers. Earliest start 7am EST, latest 9am EST. 8 hours daily.
| Candidate Requirements | ||||
| Education/Certification | Required: Bachelor’s degree in related field or equivalent experience | Preferred: | ||
| Licensure | Required: RN | Preferred: | ||
| Must haves: Excel skills- basic, flexibility, self-driven, Nice to haves: sales experience, health insurance background, knowledge of chronic conditions Disqualifiers: poor documentation and follow through Performance indicators: Provider return of appointment agendas | |||
| 1 | Critical thinking and problem-solving | ||
| 2 | Organization and time management | |||
| 3 | Clear verbal and written communication | |||