Quality Program Specialist

Physical Requirements:

The employee is regularly required speak and hear sufficiently to communicate effectively by phone or in person, at normal volumes. Specific vision requirement includes adequate vision to read correspondence, computer screen, forms, etc. The employee is to have good manual dexterity. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The employee must frequently lift, carry, and/or move up to 20 pounds or more. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Qualifications:

LPN License, or diploma from a Medical Assistant program. Minimum of one year experience. Strong clinical and computer skills and excellent interpersonal skills. Must be proficient in Excel spreadsheets and interpreting reports..

Basic Functions:

Oversee and monitor quality improvement activities, promote improvement of quality measures across the organization while remaining in compliance with measures, regulations for payers, various programs, and state/federal guidelines. Responsible for the supervision of support staff.

Duties and Responsibilities:

• Maintain knowledge base on wide variety of clinical measure and pay-for-performance definitions and provide analysis for the measurement of outcomes such as UDS, MIPS, HEDIS, Medicaid Promoting Interoperability, payer requirements, analyzing/interpreting reports, WVHN, Million Hearts, Health Homes, and Chronic Care Management.
• Work with various vendors, the FamilyCare management team, and staff on quality improvement projects.
• Oversee data collection through staff orientations and trainings. Run report audits and provide regular report feedback.
• Document and report the results and accomplishments of quality improvement initiatives to staff, providers, administration, quality assurance committee, and board of directors as appropriate.
• Establish strong relationships with all system users through on-site visits to understand their support requirements and priorities. Training provided as applicable for system users.
• Consult as needed with other departments and agencies to develop and implement solutions related to quality, processes, and procedure.
• Ensure all quality indicators are followed.
• Other related duties as assigned.