Quality Improvement Specialist

Group Health Cooperative • Altoona, PA

19h • Onsite

About The Position

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.

Requirements

• Minimum of an Associate degree or certification in related field.
• Proficient in the use of Microsoft Office Suite.
• Ability to build trust with business partners across organizational boundaries.
• Strong interpersonal skills—ability to effectively communicate with all levels and functional areas within the organization.
• Strong written and verbal communication skills.
• Ability to work independently.

Nice To Haves

• Nursing or clinical experience preferred.

Responsibilities

• 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.

Benefits

• three weeks of vacation the first year
• a generous retirement plan
• health and dental insurance
• a wellness program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree