Senior Patient Accounting Specialist
INTEGRIS Health
Senior Analyst, Health Care Quality Management
CVS Health
full-time
Posted on:
Origin: • 🇺🇸 United States • Florida
Visit company websiteSalary
💰 $46,988 - $91,800 per year
Job Level
Senior
About the role
- Designs and implements a quality management strategy that meets internal and external constituent expectations for demonstrating quality outcomes, including National Committee for Quality Assurance (NCQA) and state regulators for Medicaid and CHIP.\n
- Links the quality management activities to business goals by using innovation, integration, and information.\n
- Participates in the development and ongoing implementation of Quality Management (QM) work plans and activities, including support of all accreditation activities and contract requirements.\n
- Analyzes and reports on findings on health plan activities and performance.\n
- Supports accreditation minimally for health plan, health equity, and long term supports and services\n
- Supports quality contract requirements, including performance improvement projects (PIPs), analysis of quality improvement activities, and quality program evaluation\n
- Measures adherence to clinical and preventive health guidelines\n
- Assists in the development and implementation of QM projects and activities\n
- Converts results of data analysis into meaningful business information to disseminate conclusions about the overall function of the department\n
- Supports quality committees execution and reporting to quality committees\n
- Performs quantitative and qualitative data analysis to achieve operational targets\n
- Prepares QM documents that adhere to the interpretation and application of business requirements
Requirements
- Candidate must reside in Florida (FL)\n
- 5 years experience in managed care quality and/or 3 years in Medicaid managed care\n
- Must be analytical and able to interpret data\n
- Must be proficient in all Microsoft office Suite, especially Microsoft Excel and PowerPoint\n
- Must be articulate and able to communicate to multiple internal and external stakeholders
