Demo

Quality Improvement Specialist Senior

Sunflower Health Plan
Ford, KS Full Time
POSTED ON 1/23/2025 CLOSED ON 2/19/2025

What are the responsibilities and job description for the Quality Improvement Specialist Senior position at Sunflower Health Plan?

Transforming the Health of Communities, One Person at a Time

Position Purpose:

The Senior Quality Improvement Specialist is responsible for coordinating assigned regulatory, accreditation, clinical quality and/or service improvement programs. This role serves as a leader for assigned health services initiatives, handling multiple large-scale complex initiatives.

  • Leads and manages multiple complex initiatives that impact the quality or effectiveness of healthcare delivery and/or healthcare services provided to members.
  • Ensures that clinical and service quality improvement programs and initiatives are compliant with applicable accreditation, state, and federal requirements.
  • Conducts an assessment of programs, initiatives, and interventions to ensure goals and objectives were met and refines activities, as needed, to improve the effectiveness and outcomes.
  • Manages vendor oversight and ensures compliance.
  • Develops targeted activities to improve Star Ratings, HEDIS, CAHPS, HOS, provider satisfaction, and other identified performance measures.
  • Develops and implements project-related communication, including member/physician mailings, IVR scripts, emails, business plans, graphics, and maintains minutes and agendas.
  • Participates in the development and maintenance of annual quality improvement program documents and evaluations, compliance audits, policies, and procedures.
  • Develops internal reports to demonstrate progress on each initiative/project and presents to senior-level staff.
  • Describes outreach initiatives, potential/experienced barriers, and activities to resolve issues and improve outcomes.
  • Leads and/or participates in multi-department/cross-functional committees and work groups supporting key initiatives, prepares reports, data, agendas/minutes, or other materials for committee presentation and management.
  • Identifies areas of improvement within the organization and works collaboratively with other departments to develop clinical and non-clinical performance improvement projects.
  • Researches best practices, national and regional benchmarks, and industry standards.
  • Develops collaborative relationships with contracted providers or provider groups to promote participation in quality improvement collaboratives to improve clinical care outcomes.
  • Maintains current knowledge of industry trends and regulations for enterprise-wide adoption to assure quality and effectiveness of healthcare delivery and/or healthcare services provided to members.

Education/Experience:

A Bachelor's Degree or equivalent experience with a clinical license or Master's Degree in a related health field (i.e., MPH or MPA) is required. A valid state clinical license is preferred, and certification as a Certified Professional in Healthcare Quality (CPHQ) is also preferred.

Three to five years of managed care experience in a healthcare environment, with experience in compliance, accreditation, service, or quality improvement, is required. Complex project management experience is also required. Experience with Medicare and/or NCQA is preferred.

Quality Improvement Coordinator
PrairieStar Health Center, Inc. -
Hutchinson, KS
Director of Quality Improvement
McPherson Hospital -
McPherson, KS
Senior Continuous Improvement Manager
Quest Diagnostics -
Johnson, KS

If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

What is the career path for a Quality Improvement Specialist Senior?

Sign up to receive alerts about other jobs on the Quality Improvement Specialist Senior career path by checking the boxes next to the positions that interest you.
Income Estimation: 
$99,704 - $121,947
Income Estimation: 
$124,827 - $154,865
Income Estimation: 
$103,834 - $132,004
Income Estimation: 
$133,601 - $190,698
Income Estimation: 
$80,350 - $103,771
Income Estimation: 
$85,233 - $106,862
Income Estimation: 
$98,205 - $115,680
Income Estimation: 
$56,514 - $75,682
Income Estimation: 
$80,350 - $103,771
Income Estimation: 
$85,158 - $98,800
Income Estimation: 
$85,233 - $106,862
Income Estimation: 
$103,834 - $132,004
This job has expired.
View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

Job openings at Sunflower Health Plan

Sunflower Health Plan
Hired Organization Address KS Full Time
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Managem...
Sunflower Health Plan
Hired Organization Address Topeka, KS Full Time
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our commun...
Sunflower Health Plan
Hired Organization Address Lenexa, KS Full Time
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our commun...
Sunflower Health Plan
Hired Organization Address KS Full Time
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our commun...

Not the job you're looking for? Here are some other Quality Improvement Specialist Senior jobs in the Ford, KS area that may be a better fit.

Quality Improvement Specialist Senior

Sunflower Health Plan, Winfield, KS

Quality Improvement Specialist Senior

Sunflower Health Plan, Schoenchen, KS

AI Assistant is available now!

Feel free to start your new journey!