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Quality Improvement Specialist

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Clinical & Pharmaceutical
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18336 Requisition #
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What you will get to do:

 

Medica’s Quality Improvement Specialist is responsible for leading, coordinating and overseeing projects supporting the organization’s quality improvement programs, principally the health plan accreditation for NCQA. This Specialist will assess compliance with accreditation requirements, identify gaps and risks, and facilitate corrective action.

 

In addition, this Specialist will lead the organization’s preparation for accreditation surveys, including committee/work group facilitation, evidence collection, document preparation and survey logistics. Other responsibilities may include quality of care review, delegation oversight or related compliance activities.

 

Qualifications:

  • Bachelor's Degree in Business, finance, healthcare administration or clinical field strongly preferred
  • 5+ years of related experience including project management, health care industry experience, experience working within accreditation or credentialing, and understanding of regulatory and accreditation requirements
  • Experience in interpreting, applying and implementing regulatory and accreditation requirements
  • Experience leading/facilitating committees and work groups; ability to work effectively with diverse stakeholders around a common goal
  • Experience in managed care or related health care setting, including knowledge of data sources, products and operational policies and procedures

Certification/Licensure:

  • Certified Professional in Healthcare Quality (CPHQ) certification preferred, however not required

 

Skills and Abilities:

  • Demonstrated knowledge of accreditation standards (NCQA, URAC, or Joint Commission) and state and federal regulatory agencies and requirements (MDH, DHS, CMS)
  • Demonstrated success in managing complex projects with a high degree of initiative; demonstrated experience leading and delegating to indirect reports
  • Excellent verbal and written communication skills
  • Strong organizational and time management skills; ability to manage multiple tasks and priorities; strong attention to detail
  • Strong analytical and problem-solving skills; demonstrated experience with data collection, assessment tools, analysis and reporting; skilled user of quality tools and techniques
  • Strong interpersonal and relationship-building skills; ability to represent organization to external customers
  • Strong computer skills: word processing, spreadsheet and database applications

 

 

Equal Opportunity Employer Including Veterans and Disabled Individuals

Thrive Together.
At Medica, you'll enjoy working with talented people who share a mission to meet our customers' needs.
 
Grow Together.
Medica will support you through your personal growth and involvement in the community.
 
Succeed Together.
Medica provides resources that allow you to take charge of your health and career.

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