Sr Specialist, Quality Interventions/QI Compliance (Remote in MS)
About the position The Senior Specialist, Quality Interventions / QI Compliance plays a crucial role in overseeing and implementing healthcare quality improvement initiatives and education programs. This position is responsible for ensuring compliance with quality standards, conducting data collection and reporting, and leading NCQA accreditation surveys and federal/state quality improvement compliance activities. The role requires significant travel and collaboration with various departments to enhance quality interventions and compliance efforts. Responsibilities • Provide project, program, and initiative-related direction and guidance for other specialists within the department and collaboratively with other departments. • Implement key quality strategies, including management of provider, member, and community interventions. • Prepare for Quality Improvement Compliance surveys and other required quality activities. • Monitor and ensure timely and accurate completion of key quality activities, presenting results to management as needed. • Write narrative reports interpreting regulatory specifications and documenting findings of department interventions. • Create and manage documentation to maintain critical quality improvement functions. • Lead quality improvement activities and discussions with other departments. • Evaluate project/program activities to identify opportunities for improvement. • Report any gaps in processes to the Manager and Director. Requirements • Bachelor's Degree or equivalent combination of education and work experience. • Minimum 3 years' experience in healthcare, with at least 2 years in health plan quality improvement or managed care. • Demonstrated solid business writing experience. • Operational knowledge and experience with Excel and Visio. Nice-to-haves • Preferred field: Clinical Quality, Public Health or Healthcare. • 1 year of experience in Medicare and Medicaid. • Experience with data reporting, analysis, and interpretation. • Active, unrestricted Certified Professional in Health Quality (CPHQ). • Active, unrestricted Nursing License (RN may be preferred for specific roles). • Active, unrestricted Certified HEDIS Compliance Auditor (CHCA). Benefits • Competitive benefits and compensation package. Apply tot his job