The QI Associate provides support to the QI Director in the development, implementation, and evaluation of the Plan’s overall Quality Improvement (QI) Program, to identify trends, prioritize projects, recommend improvements, and ensure compliance with regulatory requirements. Assists with the investigation of quality of care reviews, appeals, grievances, patient care issues, and participates in other QI activities including collection, organization and management of medical records for QI activities including but not limited to HEDIS, HOS, Star Rating Program, Appeals, Grievances, focused interventions and oversight of any delegated activities. The QI Associate 2 is cross trained in all QI Department tasks and activities but will each have primary responsibilities
Minimum one year experience in a managed care setting or equivalent
Basic knowledge of the quality improvement process and applicable regulatory requirements.
Proficiency with Microsoft Excel, Word, Power point and Outlook is required, some Access desired.
Minimum Associate degree required, BA Science preferred or other health related field
Ability to read and interpret documents such as safety rules, operating instructions, and procedure manuals.
Ability to write routine reports and correspondence.
Ability to communicate effectively with groups of customers or employees of the organization.
Good interpersonal, problem solving skills. Excellent oral and written communication skills.
Ability to interact with all levels of staff in a diplomatic manner.
Ability to multi task and be comfortable in a fast paced environment.
Good prioritization skills, comfortable with deadlines
Able to work independently or with minimal supervision; team player; resourceful