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Healthcare Quality Management Specialist
Medical Review Institute of America, LLCQuality Management Specialist partnering with leadership for quality improvement initiatives. Leading structured quality improvement efforts in a clinically-driven healthcare company.
About the role
Key responsibilities & impact- partner with key members of leadership for the design and implementation of Quality Management procedures
- ongoing improvement efforts, and other team projects with the aim of achieving organizational, accreditation, and regulatory requirements
- Review and analyze current processes related to the application and implementation of policies, procedures, and practices
- provide leadership with recommendations for updates to comply with the current regulatory and accreditation requirements
- Identify gaps in efficient process workflow and suggests steps for quality process improvement
- Measure process performance using valid and accurate methods; analyze trends, variation, and process stability to determine if defined performance metrics are met and identify areas of risk
- lead and support structured quality improvement initiatives (e.g. DMAIC or equivalent)
- Manage and lead Quality Improvement Projects (QIPs)
- Manage and ensure execution of CAPAs, including documented root cause analysis, defined success metrics, implementation tracking, and post-implementation validation demonstrating sustained improvement in coordination with the Clinical Quality, Compliance, and Operations leaders
- Serve as liaison between clients and MRIoA’s quality management department as needed
- Assist leadership in establishing and reporting quality metrics
Requirements
What you’ll need- Minimum of 5 years’ experience in a quality management role
- Demonstrated experience applying structured quality improvement methodologies (e.g., Lean, Six Sigma, DMAIC) required
- Working knowledge of managed care and utilization review accreditation standards, including URAC and NCQA, and multi-state regulatory requirements
- Six Sigma Green Belt or equivalent certification preferred
- Exceptional customer service skills
- Exceptional analytical and critical thinking skills
- Excellent oral and written communication skills and interpersonal skills
- Exceptional orientation to detail
- Excellent organizational skills
- Ability to work under pressure and meet deadlines while managing multiple high priorities and supporting a flexible schedule
- Knowledge and understanding of the Company’s clients, products, departments, and workflows
- Personal computer literacy and competency in use of Microsoft Word, Microsoft Excel (intermediate skill), Power Point and PowerBI
- Ability to maintain a high level of objectivity and confidentiality
- Experience in quality improvement activities within a healthcare, health insurance and/or managed care organization preferred
- Experience in supplying small group and individual training preferred
- Experience in research beneficial and preferred
Benefits
Comp & perks- healthcare, vision and dental insurance
- a generous 401k match
- paid vacation
- personal time
- holidays
- Growth and training opportunities
- A team atmosphere with fun events and prizes scheduled throughout the year
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Quality Improvement MethodologiesProcess Performance MeasurementRoot Cause AnalysisAccreditation Standards KnowledgeData AnalysisQuality Metrics ReportingCAPA ManagementTraining ExperienceResearch Skills
Soft Skills
Exceptional Customer ServiceAnalytical ThinkingOral and Written CommunicationInterpersonal SkillsOrganizational Skills
Certifications
Six Sigma Green Belt