What are the responsibilities and job description for the Specialist, Quality Improvement position at Independent Living Systems?
ABOUT US
Join us in making a career in Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years. Independent Living Systems, LLC and its subsidiaries offer a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid, and Dual-Eligible Market. ILS provides tailored integrated solutions aimed at improving health outcomes while rebalancing costs, addressing social determinants of health and connecting members with community-based resources.
Position Summary
The Specialist, Quality Improvement (QI Specialist) collaborates with teammates and other colleagues to ensure that external, subcontracted providers are compliant with CalAIM, Health Plan, and internal ILS policies and procedures. To achieve this goal, the QI Specialist performs audits and assists in the development of strategies, plans, and educational materials to address performance issues and gaps. Monitors provider progress to ensure goals/targets are being met.
Essential Functions
- Conduct performance/compliance audits
- Evaluate performance against established benchmarks and targets.
- Participate in creating strategies and action plans to address performance issues, gaps, and areas for improvement.
- Assist in designing and presenting provider educational activities to improve compliance.
- Analyze and evaluate collected data to identify trends, patterns, and changes in performance.
- Performs other duties as required or assigned.
Education and Experience
Education: Bachelor’s Degree (preferred) in health care field, communications, social work, or similar field
Minimum Experience: years’ experience in health care, care management, and education field
Knowledge: Familiarity with the California Advancing and Innovating Medi-Cal (CalAIM) program, Medi-Cal, vulnerable populations, and managed care environment (preferred)
Required Skills
- Excellent interpersonal skills
- Outstanding verbal and written communication skills
- Self-disciplined with excellent analytical and problem-solving skills
- Technological proficiency including knowledge of Microsoft Office Platform, as well as Internet and Tele-conferencing resources
- Ability to work well with others, including staff, clients, members, and the public
EEO STATEMENT
In compliance with the Drug-Free Workplace Act of 1988, Independent Living Systems has a longstanding commitment to provide a safe, quality-oriented, and productive work environment. Alcohol and drug abuse pose a threat to the health and safety of ILS employees and to the security of the company's equipment and facilities. For these reasons, ILS is committed to the elimination of drug and alcohol use and abuse in the workplace. Independent Living Systems, LLC, and its subsidiaries, including FCC, provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, disability, ancestry, or any other characteristic protected by state, federal, or local law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
