Location: Mishawaka,IN, USA
Employment Type:
Full time
Shift:
Day Shift
Description:
JOB SUMMARY
The Quality Improvement Specialist assists in the continuous quality improvement and organizational excellence of Select Health Network. The Quality Improvement Specialist will have the primary responsibility of coordination assistance directly related to key quality improvement (QI) activities and projects. Activities include but are not limited to data abstraction, generating reports for internal and external purposes, data entry, member outreach to close gaps in care, maintaining member records, chart reviews, and preparation of member mailings to assist in quality measure outcomes.
JOB DUTIES
* Coordinates with provider offices to gather data and perform chart review as needed.
* Collects data from one or more sources including encounters, claims, and other data sources to improve identified quality outcomes and population health goals. Evaluates reports for accuracy.
* Responsible for maintaining the integrity of the data by entering information into the appropriate quality documentation system.
* Assists in the planning, coordination, and evaluation of QI learning and education sessions related to quality initiatives.
* Completes member outreach to close gaps in care. Maintains quality customer service at all times with patients, exhibiting courteous and professional behavior.
* Understands and stays up to date with current HEDIS measures.
* Performs other duties consistent with purpose of job as directed and complete special projects as assigned.
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JOB SPECIFICATIONS AND CORE COMPETENCIES
Education: Knowledge of a wide range of clinical areas and medical terminology normally acquired by completing a Bachelor's degree in a clinical area.
Experience: Experience in data mining and analysis in a managed care setting. Knowledge of performance improvement measurement systems and the metrics used to assess performance. Experience in Quality Improvement and/or Case Management is preferred. Computer proficient and appropriate telephone etiquette skills required. One year of managed care experience preferred.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.