Your future role at a glanceLocation: Remote - Must reside in Texa
Facility: Ascension Care Management Insurance
Department: Quality Management
Schedule: Day Shift | Full Time | Monday-Friday
Salary: $75,295.00 - $110,834.59
Eligible for an annual bonus incentive
#LI-AM2
How you'll make an impact in this role- Plan, design, implement, and maintain a comprehensive program of continuous quality improvement (CQI). Assists in educating new staff, providers about the quality improvement (QI) systems and requirements. Knowledge of quality improvement principles, practices and procedures.
- Oversees complex HEDIS project lifecycles-including data analysis, medical record abstraction, chase logic, thorough knowledge or Performance Improvement Projects (PIPs) and is able to apply that knowledge in PIP writing development, update, and analysis of data in PIPs.
- HEDIS experience, planning of the whole HEDIS project from start to end, how to complete the HEDIS Roadmap, understand the process and planning of medical record review and abstraction. Must be able to analyze HEDIS data to develop interventions for gaps in care.
- Maintains deep working knowledge of URAC/NCQA standards, the Uniform Managed Care Contract, and state-specific programs like Texas Health Steps and Alternative Payment Models.
What minimum requirements you'll needLicensure / Certification / Registration:
- Certification specializing in Lean Healthcare Mgmt preferred.. Licensure required relevant to state in which work is performed
- Project Mgmt Professional preferred. Licensure required relevant to state in which work is performed
- Registered Nurse preferred. Licensure required relevant to state in which work is performed
Education:
- High School diploma equivalency with 2 years of cumulative experience OR Associate'
degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.
What additional preferences we're seeking- Bachelor's Degree in Nursing is a must-have.
- 2+ years of Registered Nurse (RN) experience and 2+ years of HEDIS experience
- Performance Improvement Projects (PIP)
- Must reside in Texas
Responsibilities- Plan, design, implement, and maintain a comprehensive program of continuous quality improvement (CQI). Assists in educating new staff, providers about the quality improvement (QI) systems and requirements. Knowledge of quality improvement principles, practices and procedures.
- Oversees complex HEDIS project lifecycles-including data analysis, medical record abstraction, chase logic, thorough knowledge or Performance Improvement Projects (PIPs) and is able to apply that knowledge in PIP writing development, update, and analysis of data in PIPs.
- HEDIS experience, planning of the whole HEDIS project from start to end, how to complete the HEDIS Roadmap, understand the process and planning of medical record review and abstraction. Must be able to analyze HEDIS data to develop interventions for gaps in care.
- Maintains deep working knowledge of URAC/NCQA standards, the Uniform Managed Care Contract, and state-specific programs like Texas Health Steps and Alternative Payment Models.
QualificationsLicensure / Certification / Registration:
- Certification specializing in Lean Healthcare Mgmt preferred.. Licensure required relevant to state in which work is performed
- Project Mgmt Professional preferred. Licensure required relevant to state in which work is performed
- Registered Nurse preferred. Licensure required relevant to state in which work is performed
Education:
- High School diploma equivalency with 2 years of cumulative experience OR Associate'
degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.
