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Clinical Quality Improvement Supervisor
2 months ago
Join our team of dedicated professionals at Absolute Total Care as a Clinical Quality Improvement Supervisor. In this role, you will play a critical part in ensuring the highest quality of care for our 28 million members.
Job Summary:We are seeking a highly skilled and experienced Clinical Quality Improvement Supervisor to join our Medical Management/Health Services team. As a Clinical Quality Improvement Supervisor, you will be responsible for supervising and coordinating team activities to ensure HEDIS data accuracy and reporting. You will also collaborate with internal and external stakeholders to ensure HEDIS and CAHPS initiatives are fully integrated throughout the organization.
Key Responsibilities:- Coordinate activities, resources, methods, and procedures to achieve improvement in HEDIS measures with business leaders and cross-functional departments.
- Formulate and ensure compliance with HEDIS technical specifications, policies, operating procedures, and goals in compliance with internal and external guidelines.
- Supervise daily activities of staff to promote quality improvement and efficient methods.
- Assist with comprehensive analysis of HEDIS measures, barriers, and opportunities and present results of improvement efforts and ongoing performance measures.
- Coordinate clinical quality metrics and HEDIS processes and results.
- Coordinate cross-functional processes to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities.
- Manage and coordinate HEDIS projects, including assignment of nurses, adherence to plan timelines, and vendor oversight for timeliness and quality.
- Ensure compliance for all quality audits and maintain all data and process controls.
To be successful in this role, you will need a Bachelor's degree in Business Administration or Health Care Administration or equivalent experience. Additionally, you will require 3+ years of quality improvement, HEDIS project management, or healthcare-related experience. A working knowledge of NCQA and HEDIS programs is also essential.
What We Offer:At Absolute Total Care, we offer a comprehensive benefits package, including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field, or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
We are an equal opportunity employer that is committed to diversity and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
