Allameda Alliance for Health Hiring for Quality Improvement Project Specialist I / Job Req 637834643 at Alameda, California Full Time

PRINCIPAL RESPONSIBILITIES:
Under QI Leadership, the Quality Improvement (QI) Project Specialist I is responsible for providing quality assessment and performance improvement activities that include facilitation, implementation, and quality monitoring of assigned performance improvement projects (i.e. Healthcare Effectiveness Data and Information Set (HEDIS)/Managed Care Accountability Set (MCAS), Alliance Pay-for-Performance program, State mandated Quality or Performance Improvement Projects (PIPs), Access to Care Surveys, clinical safety, or other QIHE activities) to improve health outcomes. The QI Project Specialist I conducts assessment activities and facilitates compliance with Medicare/Medicaid regulations, state licensure laws, applicable regulatory/accrediting bodies as relevant to the Quality Improvement Health Equity (QIHE) program.
Principal responsibilities include:

• Conducts focused studies to evaluate, analyze targeted areas of performance, and identify projects to improve performance.
• Compiles statistical data and write narrative reports summarizing quality assurance and improvement findings.
• Implements the execution of quality initiatives for an assigned project or program.
• Facilitates assigned QIHE projects of small to medium scale utilizing project management or quality improvement methodologies for the clinics
• In coordination with the Lead Quality Improvement Specalist or Quality Improvement Project Specialist II, participates in promotion of practice coaching principles or assistance to network providers to improve quality outcomes
• Coordinates member and provider communications as appropriate as requested
• Collaborates with Analytics on design of report generation and analysis
• Coordinates and participates in the collection of data from medical records, logs, databases and reporting systems that support performance improvement, access and availability, and clinical safety activities.
• Facilitates internal and external training on quality methodologies, quality performance, and other related quality activities.
• Prepares data reports and activities for committees and meetings.
• Participates in regulatory activities and audit preparation (i.e. Department of Healthcare Services, Department of Managed Healthcare, National Committee for Quality Assurance, etc.)
• Develops tracking mechnisms, workplans, audit tools, medical chart review processes, and reports to support QIHE program requirements and operational activities
• Participates in inter-department teams and applicable committees, sub-committees, or task forces. Comply with all regulatory and licensing agency requirements and promptly inform the applicable person(s) of changes and updates.
• Conducts outreach to providers for corrective action plan (CAP) follow up, surveys, or feedback to improve programs
• Reports and facilitate changes in standards of care as necessary.
• Support development of QI trainings, webinars, and related materials and tools for QIHE initiatives
• Prepares meeting materials and complete meeting minutes when warranted
• Performs other duties and special projects as assigned.

ESSENTIAL FUNCTIONS OF THE JOB

• Demonstrate strong verbal and written communication skills.
• Utilize project management skills and tools to facilitate one or more projects with clinics related to HEDIS/MCAS, access to care initiatives, clinic safety, or in collaboration with Population Health and Equity.
• Perform statistical data analysis and implementing projects in accordance with research design.
• Data collection, measurement, maintenance, and analysis.
• Report and presentation development to support regulatory submissions.
• Ability to prepare content and present on quality improvement activities at QI workgroups or-sub-committees.
• Coordinate and consult with Alliance departments on QI activities and projects.
• Keep abreast of healthc re industry best practices and managed care regulatory requirements.
• Comply with the organizations Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.

PHYSICAL REQUIREMENTS

Constant and close visual work at desk or computer.