Quality Specialist II

ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. Must have: - 2+ years of HEDIS related experience (where applicable) - 2+ years of quality improvement and auditing or related in healthcare field - Attention to detail and ability to work efficiently to meet deadlines and timelines - High degree of organization required - Expertise in data management, data analysis, reporting word processing, and project management skills - Strong working knowledge of Microsoft Excel, VISIO and MS Project - Knowledgeable in HEDIS (where applicable) and Accreditation (NCQA and/or URAC) requirements - Knowledge of healthcare quality improvement processes, accreditation standards, and HEDIS/performance measurement - Expertise in data management, data analysis, reporting word processing, and project management skills - Strong working knowledge of Microsoft Excel, VISIO, and/or MS Project - Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports Role Overview / Responsibilities: - Serves as a member of the quality team at the national, regional or unit level - Coordinates projects resulting in continuous quality improvement and process improvement - Supports the maintenance of a strong quality program, measured processes including URAC, NCQA, and/or HEDIS (where applicable) and reported outcomes - Coordinates assigned quality and process improvement activities which may include accreditation support, process improvement projects, quality studies, CQI (continuous quality improvement) process training for staff, prevention program coordination, care coordination initiatives, satisfaction survey coordination and follow-up, provider and member advisory groups (where applicable), tracking of adverse incidents, monitoring of performance guarantees, CAPs and customer related quality initiatives - Conducts quality control reviews and external/internal audits - Summarizes findings and prepares reports on findings - Assists in the preparation of customer audits - Conducts analyses of data findings for quality and process improvement and assists in report preparation for internal and external customers - Leads and/or supports assigned quality committees and/or work groups through comprehensive project management, ensuring that documentation is accurate and timely, agenda items presented, and follow-up actions taken - Supports the quality program with the goal to meet customer requirements and performance guarantees - Duties include monitoring and execution to meet timely deliverables - Works independently and high degree of organization required Additional Qualifications / Responsibilities: - 2+ years of HEDIS related experience (where applicable) - 2+ years of quality improvement and auditing or related in healthcare field - Attention to detail and ability to work efficiently to meet deadlines and timelines - High degree of organization required - Expertise in data management, data analysis, reporting word processing, and project management skills - Strong working knowledge of Microsoft Excel, VISIO and MS Project - Knowledgeable in HEDIS (where applicable) and Accreditation (NCQA and/or URAC) requirements - Knowledge of healthcare quality improvement processes, accreditation standards, and HEDIS/performance measurement - Expertise in data management, data analysis, reporting word processing, and project management skills - Strong working knowledge of Microsoft Excel, VISIO, and/or MS Project - Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports Title Quality Specialist II - Remote Grade 23 Work Experience - Required Quality Work Experience - Preferred Education - Required GED, High School Education - Preferred Bachelor's - Healthcare License and Certifications - Required License and Certifications - Preferred LSSGB - Lean Six Sigma Green Belt Certification - Enterprise LSSWB - Lean Six Sigma White Belt Certification - Enterprise Salary Range Salary Minimum: $53,125 Salary Maximum: $84,995