Quality Improvement Program Analyst II

2 weeks ago


Cedar Falls, Iowa, United States Iowa Total Care Full time

Transforming Healthcare: At Iowa Total Care, we are dedicated to enhancing the health of our communities, one individual at a time. As a part of our organization, you will have access to competitive benefits and a flexible work environment that supports your needs.

** This position allows for remote work from anywhere within Iowa, with minimal travel requirements (less than 20%) **

Role Overview: The Quality Program Strategist II is responsible for identifying industry trends and managing quality improvement initiatives related to HEDIS or CAHPS strategies. This role involves collaborating with stakeholders to address business challenges and proposing effective solutions that enhance operational value. You will analyze business issues, develop hypotheses, and validate conclusions to identify optimal solutions.

  • Conduct comprehensive evaluations to support HEDIS gap closure and assess member/patient experiences, identifying potential pilot programs and process enhancements to achieve sustainable quality performance objectives. This includes a thorough review of measure specifications, performance trends, stakeholder input, industry literature, and organizational initiatives.
  • Work collaboratively with assigned markets to ensure ongoing performance improvement. Develop resources and tools to facilitate HEDIS gap closure and conduct regular assessments to understand health plan needs, partnering with cross-functional teams for successful implementation.
  • Ensure compliance with state reporting requirements and maintain alignment with HHS and HPMS memos regarding quality ratings. Establish policies and procedures for quality checks on all member and provider communications to guarantee the accuracy of information and alignment with Iowa Total Care's business objectives.
  • Design, maintain, and deliver training programs for Quality Improvement staff as necessary to fulfill assigned responsibilities.
Qualifications: A Bachelor's degree in Nursing, Public Health, Business, or a related field is required; a Master's degree is preferred. A minimum of 4 years of clinical experience, along with managed care or health insurance experience, is essential. Additionally, 2 years of experience in quality management or provider partnerships is preferred.

Licensure/Certification: Preferred certifications include Registered Nurse (RN), Licensed Practical Nurse, Licensed Vocational Nurse, or Licensed Clinical Social Worker (LCSW); CPHQ certification is also preferred.

Compensation and Benefits: Iowa Total Care offers a comprehensive benefits package that includes competitive pay, health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off, and a flexible work approach, accommodating remote, hybrid, field, or office schedules. Actual compensation will be adjusted based on individual skills, experience, education, and other job-related factors as permitted by law. Total compensation may also include additional incentive forms.

Iowa Total Care is an equal opportunity employer committed to diversity and values the unique perspectives of all individuals. 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 any other characteristic protected by applicable law.



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