Remote, United States
14 hours ago
HEDIS Performance Improvement Specialist
Details Department: Total Quality ManagementSchedule: Full-Time, 8-hour Day Shift, Monday-Friday, RemoteFacility: Ascension Care Management InsuranceSalary: $75,295.00 - $104,957.00 (per year)Eligible for an annual bonus incentive

Must reside in Texas


Benefits

Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community

 


Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer.


Responsibilities

A Performance Improvement Specialist facilitates the development and definition of ideas that will improve the organization. This role supports the DCHP's quality improvement programs and coordinates quality management efforts, including development, implementation, data collection, and analysis.

 

Extensive working knowledge of HEDIS, with proven experience and knowledge of quality improvement principles, practices and procedures.n planning and managing the entire HEDIS project lifecycle.Demonstrated working knowledge of the HEDIS Roadmap completion process.Skilled in HEDIS data analysis to identify and create interventions for care gaps.Knowledgeable in the planning and process of medical record review and abstraction.Knowledge of the chase logic used in medical record review.Plan, design, implement, and maintain a comprehensive program of continuous quality improvement (CQI). Assists in educating new staff, providers about the quality improvement (QI) systems and requirements.Knowledge of quality improvement principles, practices and procedures.Deep understanding of Performance Improvement Projects (PIPs) and proven capability in their development, documentation (writing), maintenance (updates), and data analysis.Analyze medical records and supporting documentation to verify quality of care.Assist in preparing the annual QI evaluation report and plan/program documents.Possess working knowledge of the Uniform Managed Care Manual, Uniform Managed Care Contract, URAC/NCQA standards, and the ability to apply these concepts effectively to daily tasks.Possesses working knowledge of the following quality programs: Alternative Payment Models, Pay for Quality, and Texas Health Steps, with the ability to apply this knowledge to the required implementation, monitoring, and calculations for each.Possesses the maturity, sound judgment, experience, and confidence to practice independently in challenging and diverse situations.Communicate ideas clearly, concisely, and coherently. Apply balanced judgment when evaluating situations and making decisions.Demonstrated ability to remain resourceful and calm while managing multiple competing initiatives, deadlines, and deliverables, particularly during process build-out.
Requirements

Licensure / Certification / Registration:

Certification specializing in Lean Healthcare Mgmt. preferred.Project Mgmt Professional preferred.Registered Nurse preferred.Registered Nurse credentialed from the Texas Board of Nursing preferred.

Education:

High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.
Additional Preferences

Additional preferences:

Bachelor's Degree in nursing or other health science degree, a must have.2 years of registered nurse experience, preferred.2 years of HEDIS experience, preferred.Skilled in building and managing collaborative relationships, and coordinating initiatives across internal teams and outside groups, a must have.Strong communication skills for responding effectively to all internal and external inquiries and complaints, a must have.

#LI-Remote


Why Join Our Team

Ascension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it. Explore career opportunities across our ministry locations and within our corporate headquarters.

 

Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

 

Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.


Equal Employment Opportunity Employer

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws.

For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.


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