Quality Improvement Project Manager/Accreditation Specialist

1 month ago


Los Angeles, United States AIDS Healthcare Foundation Full time
Job DescriptionJob Description

Overview

AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation

Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?

If so, AIDS Healthcare Foundation is the place for you

Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.

AHF’s core values are to be:

• Patient-Centered

• Value Employees

• Respect for Diversity

• Nimble

• Fight for What’s Right

STILL INTERESTED? Please continue


Responsibilities

This candidate will have a minimum of 2+ years Managed Care Health Plan and HEDIS Project Management experience

Essential Duties & Responsibilities

Includes the following. Other duties may be assigned.

  • Supports compliance with NCQA standards and participates in NCQA survey preparation.
  • Assists with preparation for HEDIS data collection, validation audits, data submission.
  • In concert with the Quality Committees, assists in the design and implementation of programs and projects to improve HEDIS rates.
  • Supports effort to complete the annual CAHPS and Provider Satisfaction surveys.
  • Collaborates with the Information Technology Department and with the Data Analyst to obtain relevant information to track and trend quality indicators.
  • Conducts audits of Primary Care Provider and Case/Disease Management records/charts to identify areas for improved quality of care.
  • Conducts external audits of contracted network providers to maintain the quality and integrity of the network.
  • Establishes and utilizes benchmarks and thresholds as quality indicators.
  • Performs selected outcome studies.
  • Participates in developing a training program related to Quality Improvement.
  • Performs incident (complaint/grievance) investigations.


Qualifications

We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability. The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment. AHF will consider qualified applicants with criminal histories in a manner consistent with the requirements of the ordinance.



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