Quality Specialist, II
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Job Description
Quality Specialist improving Magellan Health’s healthcare quality programs through HEDIS, audits, and process improvement. Analyzing data, coordinating quality initiatives, and supporting accreditation requirements.
Responsibilities:
- Serve as a member of the quality team at the national, regional, or unit level
- Coordinate quality and process improvement activities, including accreditation support, quality studies, CQI training, prevention programs, care coordination, satisfaction surveys, advisory groups, adverse incident tracking, performance guarantees, CAPs, and customer-related quality initiatives
- Conduct quality control reviews and external/internal audits
- Summarize findings and prepare reports
- Assist with customer audit preparation
- Analyze data findings for quality and process improvement and assist with internal and external customer reports
- Lead or support quality committees and work groups through project management
- Ensure accurate and timely documentation, agenda presentation, and follow-up actions
- Support the quality program and meet customer requirements, performance guarantees, and timely deliverables
- Work independently
Requirements:
- 2+ years of HEDIS-related experience, where applicable
- 2+ years of quality improvement and auditing or related healthcare experience
- Attention to detail and ability to work efficiently to meet deadlines and timelines
- High degree of organization
- Expertise in data management, data analysis, reporting, word processing, and project management
- Strong working knowledge of Microsoft Excel, VISIO, and/or MS Project
- Knowledge of HEDIS and accreditation requirements, including NCQA and/or URAC
- Knowledge of healthcare quality improvement processes, accreditation standards, and HEDIS/performance measurement
- Excellent verbal and written skills
- Ability to enter data accurately into spreadsheets and prepare professional documents and reports
- Required education: GED or high school
- Preferred certification: LSSGB Lean Six Sigma Green Belt or LSSWB Lean Six Sigma White Belt
Benefits:
- Short-term incentives may be available
- Comprehensive benefits package
- Health benefits
- Life benefits
- Voluntary benefits
- Other benefits and perks supporting physical, mental, emotional, and financial wellbeing
- Equal Opportunity Employer
- Tobacco-free workplace
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