Quality Performance Specialist

Integrated Resources, Inc

Washington, District of Columbia

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JOB DETAILS

JOB TYPE

Contractor

SKILLS

Analysis Skills, Biology, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Documentation, Employee Retention, Federal Laws and Regulations, Healthcare, Healthcare Effectiveness Data and Information Set (HEDIS), Healthcare Management, Healthcare Quality, Maintain Compliance, Managed Care, Medicaid, Multicultural, Multilingual, National Committee for Quality Assurance (NCQA), Performance Management, Program Evaluation, Project Planning, Quality Assurance, Quality Management, Registered Nurse (RN), Regulations, Risk, State Laws and Regulations, Strategic Planning, Talent Management

LOCATION

Washington, District of Columbia

POSTED

1 day ago

Quality Performance SpecialistIntegrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.Job DescriptionReporting to the Director of Quality Management, the Quality Performance Specialist is responsible for the coordination and ongoing monitoring of QI program objectives, including the delivery of performance improvement projects for service and clinical activities, integrating the quality improvement plan into all departments and facilitating HEDIS, CAHPS and NCQA accreditation activities. Implements and supports the overall implementation of quality programs that meet or exceed applicable State, Federal and NCQA standards.Principal accountabilities include, but not limited to:Leads organizational efforts in ongoing quality improvement processes to ensure compliance with State, Federal, regulatory and accrediting body's standard requirements.Leads the cross organizational preparation for the NCQA accreditation survey project.Responsible for completion and analysis of annual HEDIS/CAHPS results and works with all areas to integrate improvement initiatives into departmental goals.Responsible for the successful implementation of the QI work plan and program description by facilitating QI throughout the organization.Responsible for overall oversight, administration, development, and strategic planning for the CLAS (Cultural and Linguistically Appropriate Services) program and access for culturally diverse, multi-lingual population.Maintains a comprehensive knowledge of Department of Public Welfare (DHH), National Committee on Quality Assurance (NCQA), Office of Minority Health (OMH) and other regulatory standards related to Cultural and Linguistically Appropriate Services activities.Develops and submits documentation and updates required to meet CLAS compliance including Annual Work Plan, Program Description, and Program Evaluation, etc.Identifies, resolves and/or escalates problematic QI areas that may place plan at risk of not achieving annual goals.Collaborates with Provider Services and Member Services to complete analysis of annual satisfaction surveys and works with all areas to integrate results into departmental goals.Responsible for oversight of delegated entities pertaining to quality improvement and credentialing policies and standards.Participates in the development, implementation and maintenance of QI policies and procedures.Serves as a resource to other departments in completing QI goals.Works professionally and efficiently with all functional areas in meeting organizational and departmental quality goals.Participates on QI committees structured to achieve outcomes success and completes committee documentation that is consistent in meeting applicable requirements.QualificationsBachelor's degree in health care related field or equivalent education and experience preferred.Preferred BSN/RN preferred not requiredMinimum of 5 years' experience in healthcare delivery required (Managed Healthcare experience preferred).Minimum of 3 years' experience in clinical or service quality improvement required.Successful management of NCQA accreditation survey preferred.Two years managed Medicaid experience preferred.Kind regards,Kavita KumariClinical RecruiterIntegrated Resources, Inc.IT Life Sciences Allied Healthcare CRODIRECT # - 732-844-8726

Quality Performance Specialist

Integrated Resources, Inc

Washington, District of Columbia

About the Company

Integrated Resources, Inc

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