QUALITY IMPROVEMENT SPECIALIST
QUALITY IMPROVEMENT SPECIALIST
The Center for Elders’ Independence is a PACE (Program of All-Inclusive Care for the elderly) organization that uses an interdisciplinary team approach to care planning and care implementation for the purpose of providing high quality, affordable, integrated health care services to the elderly, including an Adult Day Health Center, and promoting autonomy, quality of life and the ability of individuals to live in their communities.
The Position: Under the supervision of the Director of Quality Improvement, the Quality Improvement Specialist is responsible for coordinating the development and implementation of Quality Improvement initiatives, utilizing internal reports to submit quality metrics on a quarterly basis, conduct periodic data validation through chart reviews, and assist the Quality Improvement department in other capacities as needed.
Duties and Responsibilities:
Quality Assessment & Performance Improvement Program:
- Ensures timely submission of HPMS (Health Plan Management System) quality metrics to CMS (Centers for Medicare and Medicaid). Utilizes internal reports and conducts data validation on reported quality metrics quarterly.
- Tracks HPMS data; creates visuals for quarterly Quality Improvement Committee meeting.
- Run internal quality related reporting periodically and as needed; includes running immunizations reports for clinic staff.
- Collaborate with Business Intelligence team to develop Quality reports.
- Conduct annual reviews of CEI’s contracted RCFEs (Resident Care Facility for the Elderly) and SNFs (Skilled Nursing Facilities). Collaborate with RCFE and SNF partners on identified issues.
- Participate in Environment of Care rounds as the Quality representative.
- Coordinates and implements Quality Improvement and Quality Assurance projects as assigned.
- Maintains the confidentiality of all company procedures, results and information about Participants, clients or families.
- Follows all CEI Policies and Procedures; OSHA safety guidelines
- Complies with all agency training requirements.
- Maintains safe working environment by following CEI’s Safety Policies and Procedures and participating in CEI’s Safety Committee if requested.
- Maintains a courteous, helpful and professional attitude on the job.
- Displays a willingness and ability to be responsive in a warm and caring manner to all customer groups.
- Performs other duties as assigned in a positive and helpful manner.
- Bachelor’s Degree in Public Health or Health Administration or a related discipline from an accredited college or university or equivalent combination of education and experience required. Additional relevant experience in healthcare, project management, or other related areas may be substituted for Bachelor’s degree on a year per year basis.
- 1-3 years of process improvement, quality assurance, or related experience in healthcare required; familiarity with PACE or senior health care preferred.
- Demonstrated experience with Microsoft Office Suite of applications including advanced proficiency with Word, Excel, & PowerPoint.
- Two years demonstrated experience conducting data analysis.
- Exercises initiative and flexibility; able to plan, organize and meet deadlines, taking into account changing priorities.
- Experience facilitating discussions, groups or meetings.
- Strong written and oral communication skills including excellent telephone/customer service skills.
- Experience working effectively and harmoniously with a diverse staff, public and private agencies and government officials.
- Ability to work independently with minimum supervision.
- Ability to track, organize and present information that is accessible to others.
The above job description is intended to communicate the general function of the mentioned position and by no means shall be considered an exhaustive or complete outline of the specific tasks and functions that will be required. CEI reserves the right to change job descriptions, site assignments, and or work hours as required by the needs of the program. All employees are expected to perform their duties within their ability as required by the job and/or as requested by management.
SUPERVISED BY:Director of Quality Improvement
1/10/20221 of 3
Center for Elders’ Independence is a PACE (Program of All- Inclusive Care for the Elderly) organization that uses an interdisciplinary team approach to care planning and care implementation for the purpose of providing high quality, affordable, integrated health care services to the elderly, including an Adult Day Health Center, and promoting autonomy, quality of life and the ability of individuals to live in their communities. Unlike other healthcare plans, CEI is not a "fee-for-service" plan. It is a “capitation” healthcare plan. CEI is paid a set amount for each person enrolled in our program, whether or not that individual seeks care. We are a growing company that offers stability and continues to thrive.