Quality Specialist
Description
Wage Range: $24.42 - $39.06 per hour
Posted wage ranges represent the entire range from minimum to maximum. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Some positions also offer additional premiums based on shift, certifications or degrees. Job offers are determined based on a candidate's years of relevant experience, level of education and internal equity.
Job Summary:
Responsible for monitoring, analysis, and evaluation of the Quality Improvement Program (QIP)’s work plan activities to align and support organizational goals and contract requirements. Supports data collection processes by working with clinical areas and other key stakeholders. Makes recommendations to improve data collection methods, accuracy and reporting. Participates in performance improvement activities in support of departmental and organizational goals.
Primary Duties:
- Provides project, program, and initiative-related support within the department and collaboratives with other departments.
- Analyzes and trends HEDIS measures to develop a gap-in-care (GIC) strategy across multiple, high priority measures.
- Works with clinic managers to ensure quality measures are met.
- Directs patient outreach for quality gap closures.
- Care coordination for patient-assisted programs for medications and medical supplies.
- Reviews target patient lists or disease registries to identify low-and emerging-risk patients.
- Proactively seeks opportunities to improve abstraction and reporting efficiency.
- Prepares, reviews, and audits the data collected for accuracy and completeness.
- Ensures accuracy of data and quality scores by performing work with strong attention to detail and creative problem-solving skills.
- Collaborates and communicates with Population Health, Quality and Health Planet teams, Clinic Coordinator, Nurse Manager and insurance contacts to address ideas, concerns and solutions.
- Creates reports related to quality program and work plan for presentation to payor partners, committees, and senior leadership.
- Identifies and reports any gaps in processes or work plan issues that may place the department at risk of not achieving goals,
- Serves as a resource for other departments participating in quality improvement activities.
- Performs other duties as assigned.
License, Certification, Education or Experience:
REQUIRED for the position:
- Associate degree or equivalent combination of education and work experience
- 2 years of experience in healthcare with 1 year in quality improvement, value-based care, or equivalent
- Proficiency in Microsoft Office: Word, Excel, PowerPoint, and Outlook
- Experience with electronic medical record (EMR) system
- Knowledge of medical terminology
- Experience with HEDIS metrics
- Exceptional organizational skills and proven ability to effectively and proactively complete multiple projects simultaneously and meet deadlines
- Excellent communication, presentation and interpersonal skills. Must be able to communicate with individuals and groups representing all levels of the organization
- Strong attention to detail, accuracy and ability to work independently
DESIRED for the position:
- 3 years of experience in healthcare quality and/or quality improvement
- Experience in value-based care and various reimbursement models
- Experience with claims data, including billing and coding knowledge
- Registered Health Information Technician (RHIT), Medical Assistant, or LPN (must maintain license as appropriate to profession, if applicable)
- Relevant data management and data analysis experience, including use of statistical methods
- Background in Quality Improvement principles and techniques
Benefit Information:
Choices that care for you and your family
Choices that care for you and your family
At EvergreenHealth, we appreciate our employees’ commitment and contribution to our success. We are proud to offer a suite of quality benefits and resources that are comprehensive, flexible, and competitive to help our staff and their loved ones maintain and improve health and financial well-being.
- Medical, vision and dental insurance
- On-demand virtual health care
- Health Savings Account
- Flexible Spending Account
- Life and disability insurance
- Retirement plans 457(b) and 401(a) with employer contribution)
- Tuition assistance for undergraduate and graduate degrees
- Federal Public Service Loan Forgiveness program
- Paid Time Off/Vacation
- Extended Illness Bank/Sick Leave
- Paid holidays
- Voluntary hospital indemnity insurance
- Voluntary identity theft protection
- Voluntary legal insurance
- Pay in lieu of benefits premium program
- Free parking
- Commuter benefits
- Cafeteria & Gift Shop Discount
View a summary of our total rewards available to you as an EvergreenHealth team member by clicking on the link below.