Quality Performance Specialist - Report Writing / HEDIS / PIP Experience (REMOTE)
Company: Amerihealth
Location: Newark
Posted on: March 21, 2023
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Job Description:
Job Description:
\n\n\n\n Your career starts now. We're looking for the next
generation of health care leaders.\n At AmeriHealth Caritas, we're
passionate about helping people get care, stay well and build
healthy communities. As one of the nation's leaders in health care
solutions, we offer our associates the opportunity to impact the
lives of millions of people through our national footprint of
products, services and award-winning programs. AmeriHealth Caritas
is seeking talented, passionate individuals to join our team.
Together we can build healthier communities. If you want to make a
difference, we'd like to hear from you.\n Headquartered in
Philadelphia, AmeriHealth Caritas is a mission-driven organization
with more than 30 years of experience. We deliver comprehensive,
outcomes-driven care to those who need it most. We offer integrated
managed care products, pharmaceutical benefit management and
specialty pharmacy services, behavioral health services, and other
administrative services. Discover more about us at
www.amerihealthcaritas.com.\n\n\n\n\n\n\n \n\n\n\n This role is
eligible for up to $3,000.00 Sign-on Bonus for external
candidates.\n\n\n\n\n Responsibilities:\n As part of the Quality
Management team, 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. \n
Principal Accountabilities:\n\nExecutes on organizational efforts
in ongoing quality improvement processes to ensure compliance with
State, Federal, regulatory and accrediting body's standard
requirements.\nResponsible for completion and analysis of annual
HEDIS results and works with all areas to integrate results into
departmental goals. \nResponsible for the successful development
and evaluation of an annual QI work plan and program description by
facilitating QI throughout the organization. \nIdentifies resolves
and/or escalates problematic QI areas that may place plan at risk
of not achieving annual goals.\nCollaborates with Provider Services
and Member Services to complete analysis of annual satisfaction
surveys and works with all areas to integrate results into
departmental goals.\nParticipates in the development,
implementation and maintenance of QI policies and
procedures.\nServes as a resource to other departments in
completing QI goals. \nWorks professionally and efficiently with
all functional areas in meeting organizational and departmental
quality goals.\nParticipates on QI committees structured to achieve
outcomes success and completes committee documentation that is
consistent in meeting regulatory and accrediting body requirements.
\n\n Education/ Experience: \n\nAssociate's Degree or equivalent
work experience required.\nBachelor's Degree preferred.\nMinimum of
3 years in clinical or service quality improvement
required\nMinimum of 3 years in healthcare delivery required. \n\n
Other Skills:\n\nManaged Healthcare experience
preferred.\nSuccessful management of NCQA accreditation survey
preferred\nExcellent organizational, analytical and interpersonal
skills.\nExcellent written and verbal communication
skills.\nAbility to work successfully within all levels of the
organization.\nAbility to design, develop and implement projects to
address financial, quality and service improvements.\nProficient PC
skills in a windows based environment.\n
\n\n\nBack\n\n\n\n\n\n\n\n\nApply Now\n\n
Keywords: Amerihealth, Newark , Quality Performance Specialist - Report Writing / HEDIS / PIP Experience (REMOTE), Advertising , Newark, Delaware
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