• Quality Improvement Specialist

    Location US-NY-New York
    Posted Date 2 weeks ago(11/2/2018 9:15 AM)
    Job ID
    # Positions
    ArchCare Community Life
    Experience (Years)
    Work Days Per Week
    Shift Start Time
    9 AM
    Shift End Time
    5 PM
    # Hours
    9 AM - 5 PM
  • Overview

    Job Summary


    Conducts, coordinates and monitors quality activities and initiatives for the Health Plan. Maintains, monitors, and develops strategies for the evaluation of member care services. Analyzes findings and recommends performance improvement initiatives and/or corrective actions. Identifies performance and process improvement opportunities to improve Star ratings and Incentive programs. Assists management with ensuring compliance with Health plan regulatory requirements.  Responsible for providing ongoing support instruction to Interdisciplinary Care Team care management staff through continuing education. Acts as an expert resource to Leadership Team and Care Members related to policy, workflows, guidelines, clinical issues, problem resolution, and complaint resolution and other clinical or service related issues. Works under general direction.




    Essential Functions




    With the Director of Quality, conducts ongoing assessment of potential learning needs of care team members managers and health plan staff.



    Report to the Quality Team on assigned activities, established reporting indicators, and pending initiatives as required.



    Assists with audits, quality reviews, regulatory reporting and ad-hoc reporting as needed to measure the impact of quality improvement activities and initiatives.



    Provide leadership and expertise in the development of specific educational training modules within the health plan.



    Responsible for identifying, implementing, and managing quality/performance improvement strategies and compliance initiatives.



    Participates in case conferences and regulatory meetings as necessary.



    Responsible for data collection, tracking, and trending as well as other administrative support activities for the needs of the health plan.



    Collaborates to develop and implement policies, practice guidelines, educational methodologies that support the provision of evidence-based best practice standards.



    Interprets and implements ArchCare Mission Statement, Policies and Standards of Practice in relation to organization’s Goals and Objectives to all Clinical/Non-Clinical Staff.



    Performs other supervisory related duties and projects as assigned.


    Education & Experience


    Formal Education: Bachelor’s degree in education, nursing, public administration, public policy, public health or related program that provides the skills needed to conduct performance improvement activities, required. Master’s degree, preferred.

    Experience: A minimum of three (3) years of related experience working in a healthcare organization, required.

    License, Registration, and / or Certification Requirement: Yes. Certified Health Data Analyst (CHDA) certification preferred.

    Minimum Knowledge: Requires ability to interpret/extract information and/or perform arithmetic functions.

    Language Ability: Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.


    Education Requirements




    Bachelor’s degree in education, nursing, public administration, public policy, public health or related program


    Experience Requirements




    3-5 years experience in quality or education within a healthcare setting


    License Requirements




    Unrestricted New York State licensure in related field


    Skill Requirements



    Demonstrated leadership experience preferred. Excellent oral, written and interpersonal communication skills, including presentation facilitation required. Knowledge of Performance Improvement tools and methodologies preferred. Computer proficiency with a developed knowledge of Microsoft applications (Word, Excel, & PowerPoint).



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