Assists in the management of healthcare quality efforts by participating in quality data analysis, quality improvement projects, and regulatory compliance activities. Collaborates with the healthcare quality team to develop and implement quality measures, monitors performance metrics, and identifies areas for enhancement.
Job Responsibilities:
- Develops, executes and coordinates annual HEDIS project plans in alignment with QAPI and Quality/Population Health program strategies.
- Follows and supports HEDIS MRRV project metrics, reports and remediates findings. Interacts with teams and HEDIS software systems to ensure data accuracy and timely reporting.
- Develops tactical and operational quality improvement plans, including defining project scope, objectives, deliverables, timelines, and resource allocation with respect to HEDIS medical record review.
- Collects, assesses and interprets data related to HEDIS quality metrics, outcomes, and performance indicators to identify trends and escalates remediation needs as appropriate.
- Collaborates with various stakeholders, such as healthcare providers, pharmacists, and other internal teams to facilitate the execution of quality improvement initiatives and assess results.
- Leads performance improvement projects aimed at enhancing overall healthcare quality, reducing errors, and improving operational efficiency.
- Develops and delivers education and training programs to enhance the clinical knowledge and skills of healthcare providers and staff.
Skills:
- 3-5 Years Healthcare Quality with HEDIS system experience
Education/Experience:
- Bachelor’s degree or equivalent experience.
- Master’s degree preferred
