Quality Improvement Coordinator - Quality Improvement - Full Time - Days
At Paramount, we offer insurance to both large and small groups and also cater to Medicare (Paramount Elite) subscribers in northwest Ohio and southeast Michigan. Our Medicaid product (Paramount Advantage) services those living in the state of Ohio. We maintain an accreditation by the NCQA – the National Committee for Quality Assurance – for our Ohio HMO, Elite and Advantage products. We’re also part of ProMedica, which is ranked the second most integrated health system in the U.S. and No. 1 in the Midwest.
Our mission is to improve your health and well-being. So we’re committed to your wellness with various initiatives, such as preventive services, online knowledge, health risk assessments, our Steps2Health disease management programs, health fairs, and more.
The Quality Improvement Coordinator serves as an interdepartmental and intradepartmental resource for quality improvement. Develops and implements quality improvement activities and programs to assure compliance with National Committee for Quality Assurance (NCQA), Ohio Department of Medicaid (ODM) and the Centers for Medicare and Medicaid Services (CMS) requirements for Medicare and Market Place.
- Designs and coordinates quality assurance and quality improvement activities to positively impact measures identified in the ODM provider contract, as STAR ratings measures by CMS and as required by NCQA for prevention and wellness. 30%
- Analyzes outcomes of quality improvement activities, identifying barrier to success and ways to mitigate those barriers. Documents planned activities and outcomes in the annual QI Program Work Plan and QI Evaluation. 15%
- Implements quality improvement activities approved by the Medical Advisory Council to ensure the delivery of high quality, cost-effective health care to high-risk populations. Provides interdepartmental support for quality improvement activities to assure understanding of the quality improvement program and adherence to the quality improvement work plan. 30%
- Performs HEDIS data collection to support CMS, ODJFS compliance and NCQA accreditation. 10%
- Collaborates with other Paramount Departments and ProMedica business units on development and support for special projects and initiatives. 5%
- Maintains databases, enters/stores documents into appropriate applications, performs member/provider follow-up as needed. 5%
- Other duties as assigned. 5%
- Education: Healthcare related field.
- Knowledge of quality improvement principals
- Ability to plan, coordinate and organize multiple priorities
- Excellent customer service skills
- Proficiency using Microsoft Office programs, especially Excel, Word, Power Point, and Access
- Exceptional written, telephonic, and oral communication skills
- 3-5 years’ experience in health care and quality Improvement initiatives.
- RN preferred or Bachelor’s Degree in Public Health or Population Health preferred
- 3-5 years in managed care preferred.
- Self-motivated and able to work independently; ability to maintain focus on long range goals
- Strong analytic and organizational skills; attention to detail
ProMedica is a mission-based, not-for-profit integrated healthcare organizational headquartered in Toledo, Ohio. For more information, please visit www.promedica.org/about-promedica
Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact firstname.lastname@example.org
Equal Opportunity Employer/Drug-Free Workplace
My Saved Jobs
You have no saved jobs.