** This position will report to the office **
This position is responsible for managing staff responsible for quality improvement projects and providing leadership and consultation on activities related to the successful completion of Quality Improvement projects to meet Federal and contractual regulations and accreditation requirements (i.e., NCQA, URAC etc.), as well as coordinating HEDIS and quality improvement activities that support the Federal Employee Program (FEP) quality improvement programs.
REQUIRED JOB QUALIFICATIONS:
* Bachelor Degree in Health Services, Registered Nurse (RN) or Registered Physician Assistant (RPA) with current, unrestricted license.
* 2 years of managed care or health plan experience.
* 2 years of medical surgical and/or Quality Improvement and Utilization Review experience.
* 2 years leadership, supervisory or management experience.
* Knowledge of medical terminology and procedures.
* Experience in using Total Quality Management (TQM)/Continuous Quality Improvement (CQI) concepts.
* Verbal and written communications skills in preparing recommendations and written documentation and facilitating work groups.
* Project management experience and skills. (3-5 years experience i.e. HEDIS).
* Knowledge of accreditation agency requirements ( i.e., NCQA, URAC).
* Knowledge of Federal and State regulatory requirements related to the Affordable Care Act.
* PC experience utilizing Microsoft Windows based products and database experience.
* Ability and willingness to travel, including overnight stays.
PREFERRED JOB QUALIFICATIONS:
* 3-5 years supervisory or management experience
* 3-5 years HEDIS project management experience
* 3-5 years developing training materials and documents
* 3-5 years facilitating multi-departmental project teams
* Registered Nurse (RN) preferred with current, unrestricted license
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Apply on company website