QI Specialist
Job Summary
Independently perform quality related functions within the Quality Department of a
Essential Functions
- Coordinate assigned quality and process improvement activities which may include:
- Accreditation support
- Process improvement projects
- Quality studies
- CQI process training for staff
- Prevention program coordination
- Care coordination initiatives
- Satisfaction survey coordination and follow-up
- Provider and Member Advisory Groups
- Tracking of adverse incidents
- Monitoring of performance guarantees
- Provider profiling support
- Conduct quality control reviews and internal audits. Summarize findings and prepare reports on findings. Assist in preparation for customer audits.
- Conduct analyses of data findings for quality and process improvement and assist in report preparation for internal and external customers.
- Support assigned quality committees and work groups through comprehensive project management ensuring that documentation is accurate and timely, agenda items presented and follow-up actions taken.
Minimum Requirements
Education: BA/BS
Licensed clinician- LPN, RN, LMSW, LCSW, LAC, LPC, or LPE license.
Experience: 3-5yrs.
Job Specific: 1-3 yrs quality improvement/auditing or related in healthcare field
Will accept an equivalent combination of experience and education.
Other: Knowledge of quality improvement processes and performance measurement. Attention to detail and able to work efficiently to meet deadlines and timelines. High degree of organization required. Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports.
Computer Skills: Expertise in data management, data analysis, reporting word processing, and project management skills
Preferred Qualifications
Education: MA. Experience in healthcare. Licensed clinician- LPN, RN, LMSW, LCSW, LAC, LPC, or LPE license.
Computer Skills: Expertise in Microsoft Excel, VISIO and MS Project
Experience: Managed care and/or managed behavioral healthcare
Knowledge, Skills, Abilities: Skills in research methodologies
