Senior Quality Compliance Professional
About The Position
The Senior Quality Compliance Professional/EPSDT Maternal Child Health Manager works within the Quality Improvement Team. The Senior Quality Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Quality Compliance Professional uses quality compliance and improvement tools and methodology to assess, implement, and evaluate activities to monitor and continuously improve EPSDT and maternal health services and rates for Ohio Medicaid enrollees. The Senior Quality Compliance Professional has proven data analysis skills and a strong knowledge of EPSDT and maternal health requirements. The Senior Quality Compliance Professional is frequently required to interpret and analyze data to identify new creative interventions to increase EPSDT screening rates, improve access to pregnancy related services, independently determine an appropriate course of action, and present these ideas/plans to governance teams/committees. They assess educational needs of internal and external teams around EPSDT and maternal health services in order to develop and implement plans to increase knowledge.
Requirements
- Must reside in the state of Ohio.
- Unrestricted Registered Nurse in the State of Ohio OR Physician's Assistant OR Master's degree in health services, public health, or health care administration or another related field OR Certified Professional in Health Care Quality (CPHQ) OR Certified Health Care Quality Management (CHCQM)
- At least 3 years of experience in either delivering EPSDT services OR Health Care Quality Improvement
- Prior experience in a fast paced insurance or health care setting
- Knowledge of EPSDT and Child Health Services
- Knowledge of Maternal and Pregnancy related services
- Understanding of healthcare quality measures (example HEDIS)
- Advanced Excel experience (pivot tables, charts, formulas)
Responsibilities
- Ensure member receipt of all EPSDT/HealthChek Services.
- Ensure member receipt of maternal health and postpartum care.
- Promote family planning services.
- Promote preventive health strategies.
- Identify and coordinate assistance for identified member needs specific to maternal/child health and EPSDT.
- Interface with community partners and pregnancy related services coordinators.
- Participate in EPSDT, maternal health and child quality performance improvement efforts.
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
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What This Job Offers
Job Type
Full-time
Career Level
Senior
