Quality Specialist Representative
: Job Details :

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience!

The Quality Specialist Representative, reporting to the Manager, brings excitement to project objectives in San Bernardino or Riverside. They liaise with practices, support budget management, and utilize agile methodologies for project performance tracking. From coordinating with internal teams to risk management analysis, this role ensures projects align with IEHPs strategic quality goals. With a focus on efficiency and strategic partnerships, the Quality Specialist Representative facilitates daily operations and drives successful project completion.

Commitment to Quality: The IEHP Team is committed to incorporate IEHPs Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• Hybrid schedule
• CalPERS retirement
• State of the art fitness center on-site.
• Medical Insurance with Dental and Vision.
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development.
• Wellness programs that promote a healthy work-life balance.
• Flexible Spending Account Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

Develop practice project plans to deploy practice assessments, workflow processes, practice training, and quality improvement activities to ensure Members receive needed care

Liaise with Provider practices, with or in coordination with Provider Relations Managers, and between Quality Systems to coordinate data collection, sharing resources, and scheduling trainings

Encourage Provider offices to set and work toward quality improvement goals

Meet with Provider offices to assist with developing, implementation, and progress monitoring of quality improvement action items

Maintain accurate log of Provider visits

Facilitate pilot programs and in-services at Provider offices for quality improvement efforts

Work with Quality Systems Analysts to continuously assess the performance trends for each Practices quality improvement activities and provide recommendations/support for ongoing improvement opportunities to ensure barriers to needed care are addressed

Communicate findings, trends, and Provider feedback to the Quality Improvement Team

Actively participate in Quality Improvement and company-wide meetings to stay current on both department and IEHP activities and to share insights from Provider interactions

Perform any other duties as required to ensure Health Plan operations and department business needs are successful

Education & Experience

• Bachelors degree in any Science, Health Related field, Business, Engineering, or Information Technology from an accredited institution required
• A minimum of five (5) years of experience in a provider-facing role in a healthcare environment and program management/project management experience

Key Qualifications

• Project management software tools (e.g. JIRA, PlanView), agile methodologies and best practices, certifications preferred.
• Six Sigma, Lean, Agile, Root Cause Analysis.
• Health Plan or Hospital Federal, State and Accreditation Requirements.
• Provider Workflows and Care Coordination and Transition Management processes
• SDOH, Health Equity, Community Resources, Person-Centered Care, Alternative Care Models.
• User experience design and product innovation.

Start your journey towards a thriving future with IEHP and apply TODAY!

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA)

USD $34.41 - USD $44.73 /Hr.